### OMB No. 2025 - 0006 Expires xx/xx/xxxx

EPA Form 5300 - 26 1 

## U.S. ENVIRONMENTAL PROTECTION AGENCY **Exchange Network Grant Program Progress Reporting Form for Use by Recipients of Assistance Agreements**  Please Check: 

## □ Semi - annual report 

## □ Final Report 

### Instructions: **This form is for Exchange Network Grant recipients to report their progress. Recipients should send these** 

**to their regional grant project officer for spring reports by April 30 for the period**  **October 1**  **- March 31**  **. Fall reports**  **are due to the regional project officer by**  **October 31 for the period April 1 -**  **Sept ember 30**  **. Recipient Information:**  **Agency Name: EPA Grant Number**  **– Program Code, Number, and Amendment Number (e.g., OS**  **– 12345678**  **– 0):**  **For grants awarded before 2006 Exchange Network Grant Category (i.e., One Stop, Readiness, Implementation**  **, or Challenge): Project Manager:**  **Name: Phone:**  **Email: Funding Year:**  **Aw ard Amount:**  **Expenditures during this reporting period: Funds Remaining:**  **Reporting Period (starting and ending dates, mm/dd/yyyy):**  **Da te Report Submitted (mm/dd/yyyy):**  **EPA Project Officer to Whom Report is Submitted: Name:**  **EPA Region/Program: Focus:** 

### EPA Form 5300 - 26 2 **Progress Report Instructions:** 1. List major goals and each goal’s outputs as described in the work plan. 2. In the “Scheduled Date” column enter the dates from the grant work plan 3. In the “Completion Date” column enter the date each output completed as of the period covered by this report 4. In the Outcomes column, briefly outline how the goal or output will enhan ce the recipient’s ability to carry out its mission or result in other benefits. 5. Use **bold type** for the outputs or outcomes you achieved during the current reporting period. 6. Insert more rows if you need them by using the tab key in the last cell of the last row. **EXAMPLE Goals**  **Outputs Scheduled**  **Date Com** 

**pletion date**  **List Outcomes for Each Goal, and, if they differ,**

**each Output** 1. Begin flowing ambient air quality data through the Exchange Network. 1. Develop XML schema by. . mm/yyyy mm/yyyy E nhanced environmental decision - making due to more timely access to ambient air quality data. 2. Initiate first test data flow by mm/yyyy mm/yyyy **Goals Outputs**  **Scheduled Date**  **Com**

**pletion date**  **List Outcomes for Each Goal, and, if they differ,**

**each Outpu t** 

### EPA Form 5300 - 26 3 **Comments** Instructions: If you have had any problems during the current period please report them here. In accordance with 40 C.F.R. §30.51(f) and 4 0 C.F.R. §31.40(d), a recipient of an EPA assistance agreement mus t notify EPA of any problems, delays, or adverse conditions that will materially impair the recipient’s ability to achieve the outputs/outcomes specified in the assistance agreement work plan. **Current problems during this reporting period: Describe any**  **actions your organization has taken or plans to take to resolve the problem: If**  **you need help from EPA you may request it here: Other comments:**  **Definitions**  **Project/Program Goal:** A major objective or endpoint identified in the assistance agree ment work plan. A work plan may include one or more project/program goals. Use the goals as described in the assistance agreement work plan.  **Output:** A product, service, or implementation target that will be produced or achieved during the project/program . Outputs may be qualitative or quantitative , but they must be measurable during the assistance agreement funding period .  **Outcome:** Changes or benefits resulting from the successful achievement of the project/program activities and outputs. Outcomes ma y be environmental, behavioral, health - related, or programmatic in nature, but they must be quantitative . Outcomes may not necessarily be achievable within the assistance agreement funding period , and they can be described as short - term, intermediate, or long - term: 1) short - term
– changes in learning, knowledge, attitudes, or skills; 2) intermediate

– changes in behavior, practices, or decisions; or 3) long - term
– changes in environmental, human health, or other conditions. **Paperwork Reduction Act (PRA) Bu rden Statement:**  The public reporting and recordkeeping burden for this collection of information is estimated to average ninety minutes per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Direc tor, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

### EPA Form 5300 - 26 4