Maryland WIP Gap Closers 1. Default Section Question Title * 1. Please provide some demographic infomation. (Required.) City/Town: * State: * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: * Organization: Question Title * 2. What sector(s) will your gap closer address? Agriculture Septic Systems Point Sources Existing urban stormwater (MS4 permitted jurisdiction) Existing urban Stormwater (non-pemitted jurisdiction) New development Other Other (please specify) Question Title * 3. Please provide a short description of your idea(s). Please be brief and provide separate discussions for each idea. (Required.) Question Title * 4. Who would implement your idea? (Required.) Private citizens Local government State agency Federal agency non-governmental organizations partnership/other Other - please elaborate Question Title * 5. Will your idea be implemented statewide? Yes No Question Title * 6. Will your idea be implemented in a specific region of the state? Central Maryland Southern Maryland Western Maryland Eastern Shore Question Title * 7. Will your idea be implemented in a specific county or municipality? Allegany County Anne Arundel County Baltimore City Baltimore County Calvert County Caroline County Carroll County Cecil County Charles County Dorchester County Frederick County Garrett County Harford County Howard County Kent County Montgomery County Prince George's County Queen Anne's County Somerset County Talbot County Washington County Wicomico County Worcester County Municipality Question Title * 8. If you checked municipality in Question 7, please provide the name of the municipality. Question Title * 9. What actions are needed to implement your idea? Local policy change State policy change State regulation change Local ordinance adoption or change State law adoption or change Voluntary outreach program Incentive program Other Other (please specify) Question Title * 10. Will new funding be needed to implement your idea? Yes No Question Title * 11. What are the barriers to implementing your idea? Question Title * 12. May we contact you for more infomation? Yes No Question Title * 13. If yes to #12, please provide your contact infomation Name: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Email Address: Phone Number: Done