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SUPPORTING STATEMENT

1. IDENTIFICATION OF THE INFORMATION COLLECTION

(a) TITLE OF THE INFORMATION COLLECTION

Exchange Network Grants Progress Reports (Renewal)

EPA ICR Number 2207.06, OMB Control Number 2025-0006

(b) SHORT CHARACTERIZATION

The Environmental Protection Agency’s (EPA) Office of Environmental Information 

(OEI) provides funding to EPA’s Exchange Network partners (states, territories, and federally

recognized Indian tribes) to support the development of the National Environmental Information 

Exchange Network (Exchange Network, or EN).

As a stipulation of the award, recipients are required to submit semi-annual and final 

progress reports. EPA also requires recipients to submit a quality assurance report within 90 

days of award. Since 2006, EPA has used standard forms for these reports (EPA Form 5300-26: 

Semi-Annual Progress Report Form and EPA Form 5300-27: Quality Assurance Reporting 

Form).

2. NEED FOR AND USE OF THE COLLECTION

(a) AUTHORITY/NEED FOR THE COLLECTION

The authority to gather progress performance for assistantship programs is derived 

from 2 CFR Part 200, “Uniform Administrative Requirements, Cost Principles, and Audit 

Requirements for Federal Awards.” 

Section 200.328 “Monitoring and reporting program performance,” paragraphs (b)(1) 

and (b)(2) state:

“(1) The non-Federal entity must submit performance reports 

at the interval required by the Federal awarding agency or passthrough entity to best inform improvements in program outcomes 

and productivity. Intervals must be no less frequent than annually

nor more frequent than quarterly except in unusual circumstances, 

for example where more frequent reporting is necessary for the 

effective monitoring of the Federal award or could significantly 

affect program outcomes. Annual reports must be due 90 calendar 

days after the reporting period; quarterly or semiannual reports 

must be due 30 calendar days after the reporting period. 

Alternatively, the Federal awarding agency or pass-through entity

may require annual reports before the anniversary dates of multiple 

year Federal awards. The final performance report will be due 90 

calendar days after the period of performance end date. If a 
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justified request is submitted by a non-Federal entity, the Federal 

agency may extend the due date for any performance report.

(2) The non-Federal entity must submit performance reports 

using OMB-approved governmentwide standard information 

collections when providing performance information. As 

appropriate in accordance with above mentioned information 

collections, these reports will contain, for each Federal award, brief 

information on the following unless other collections are approved 

by OMB:

 (i) A comparison of actual accomplishments to the 

objectives of the Federal award established for the period. Where 

the accomplishments of the Federal award can be quantified, a 

computation of the cost (for example, related to units of 

accomplishment) may be required if that information will be 

useful. Where performance trend data and analysis would be 

informative to the Federal awarding agency program, the Federal 

awarding agency should include this as a performance reporting 

requirement.

 (ii) The reasons why established goals were not met, if 

appropriate.

 (iii) Additional pertinent information including, when 

appropriate, analysis and explanation of cost overruns or high unit 

costs.”

 

The authority to gather quality assurance information for assistantship programs is 

derived from 2 CFR Part 1500, “Uniform Administrative Requirements, Cost Principles, and 

Audit Requirements for Federal Awards.” 

Section 1500.11 “Quality Assurance,” paragraphs (a) through (d), state:

“(a) Quality assurance applies to all assistance agreements that 

involve environmentally related data operations, including 

environmental data collection, production or use.

(b) Recipients shall develop a written quality assurance system 

commensurate with the degree of confidence needed for the 

environmentally related data operations.

(c) If the recipient complies with EPA's quality policy, the 

system will be presumed to be in compliance with the quality

assurance system requirement. The recipient may also comply with 

the quality assurance system requirement by complying with 

American National Standard ANSI/ASQ E4:2014: Quality

management systems for environmental information and 

technology programs.

(d) The recipient shall submit the written quality assurance 

system for EPA review. Upon EPA's written approval, the 

recipient shall implement the EPA-approved quality assurance 

system.”
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OEI needs these reports to ensure that grants are making progress consistent with their 

work plans and that grantees have the policies, procedures, specifications, standards, and 

documentation to produce data of sufficient quality to meet project objectives.

(b) PRACTICAL UTILITY/USERS OF THE DATA

The information provided on Semi-Annual Progress Report Forms will be used by the 

Regional Exchange Network Coordinators to monitor grant project development and 

performance. The reports will be attached to the applicable grantee’s file in the Integrated 

Grants Management System (IGMS). The same reporting form will also be used for the final 

progress report, and will be used to rate performance for future grant awards.

The Quality Assurance Reporting Form will be used to ensure grantees will use quality

assurance measures outlined in the grant’s administrative terms and conditions.

3. NON DUPLICATION, CONSULTATIONS, AND OTHER COLLECTION CRITERIA

(a) NONDUPLICATION

The information a grantee provides in their semi-annual progress report is unique to each 

project. Information concerning the status of goals and outputs for each project is not available 

from any other source. 

(b) PUBLIC NOTICE

The notice for this collection renewal was published in the Federal Register on January

15, 2015 (80 FR 2099). No comments were received.

(c) CONSULTATIONS

For this ICR action, we consulted with the EN’s ten Regional Exchange Network 

Coordinators (RENCs), as well as OEI staff. The RENC’s are EPA employees, one in each of 

the EPA’s ten regions, who specialize in environmental information, and serve as project officers 

for EN grants. The RENCs and OEI staff suggested several changes to the form, which we have 

incorporated into Exhibit A. 

(d) EFFECTS OF LESS FREQUENT COLLECTION

EN grants are usually awarded for three-year project periods. The Quality Assurance 

Reporting Form is completed only once, no more than 90 days after the award is made. As a 

stipulation of the EN grant award, a progress report is completed every six months and a final 

report is submitted no later than 90 days after the expiration or termination of the approved 

project period. Less frequent reporting could result in project mismanagement. For some 

Project Officers with many grants to manage, the semi-annual progress report is the best 

opportunity to ensure the project is on schedule to meet its goals.
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(e) GENERAL GUIDELINES

Both the Semi-Annual Progress Report Form and the Quality Assurance Reporting Form 

covered in this ICR adhere to OMB general guidelines.

(f) CONFIDENTIALITY

No pledge of confidentiality is given for grantee responses in either the Semi-Annual 

Progress Report Form or the Quality Assurance Reporting Form.

(g) SENSITIVE QUESTIONS

No sensitive questions are asked on either the Semi-Annual Progress Report Form or 

Quality Assurance Reporting Form.

4. THE RESPONDENTS AND THE INFORMATION REQUESTED

(a) RESPONDENTS/SIC CODES

Our respondents are generally employees of state, tribal, or territorial environmental 

government offices. For instance, the current grants awarded to the state of Maryland are 

managed by an employee of the Maryland Department of the Environment.

According to the 2002 NAICS codes available at www.naics.com, our respondents would 

fall into one of three categories:

921150 American Indian and Alaska Native Tribal Governments

921190 Other General Government Support

924120 Administration of Conservation Programs

(b) INFORMATION REQUESTED

Please see attachments for specific data elements (Exhibits A and B). FY 2015 guidance 

for quality assurance plans are described in the FY 2015 Exchange Network Solicitation Notice, 

Section VI-B, which requires each recipient to “submit a tailored Quality Assurance Project Plan 

(QAPP) to the EPA Regional Project Officer within 90 days of the award issuance date” as a 

condition of each grant.

(c) RESPONDENT ACTIVITIES

As previously stated, grantees are already required to report progress semi-annually on 

their projects. EN grantees have been submitting semi-annual progress reports and final reports 

to EPA Regional Offices since the National Environmental Information Exchange Network grant 

program began in 2002. EPA implemented the requirement to submit the Quality Assurance 

Reporting Form for new EN grants beginning in 2006, but the measures for quality assurance in 

a grantees’ project have been explained in the EN Solicitation Notice since 2002. 
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According to the 1995 Paperwork Reduction Act (PRA) definition of burden §3502, the 

only time and effort that the forms required from grantees are:

(A) Reviewing instructions;

(E) Completing and reviewing the collection of information; and

(F) Transmitting through email.

5. INFORMATION COLLECTED

(a) AGENCY ACTIVITIES

Once the semi-annual report and quality assurance report are received by the RENC, they

are attached to the grant’s file in the IGMS database. Semi-annual reports are also entered into 

EPA’s Central Data Exchange, which Headquarters Exchange Network staff and management 

may use to track and report grant status.

(b) COLLECTION METHODOLOGY

This information collection is form-related. The Semi-Annual Progress Report Form is 

changing and is attached in Exhibit A. The Quality Assurance Reporting Form is changing to 

clarify the instructions and is attached in Exhibit B.

Beginning with grants awarded in FY 2008, EPA requires, through the administrative 

terms and conditions, the recipients to submit semi-annual and final progress reports online via 

EPA’s Central Data Exchange (CDX) system, which replaced the former paper reports. For 

those grants awarded prior to FY 2008, the award recipient has the option of submitting semiannual progress reports to the EPA Regional Project Officer electronically (i.e., through CDX)

or in Microsoft Word, emailed to their RENC. These progress reports must be submitted within 

one month of the end of the each reporting period. The first reporting period is from the award

issuance date to March 31, 2015, and the first report will be due to the EPA Regional Project 

Officer on April 30, 2015. Subsequent reports will be due every six months thereafter, until the 

project is completed, and the reporting periods will be as follows: April 1 through September 30 

(report due October 31) and October 1 through March 31 (report due April 30). The RENC will 

upload the forms in IGMS, a Lotus Notes database that has been used by the EPA since 2000. 

To reduce burden, EPA asks that grantees not re-write their entire semi-annual progress report, 

but simply add their recent outcomes, outputs and modified dates into their semi-annual progress 

report from the previous six months. 

Recipients of all new grants must submit the Quality Assurance Reporting Form to their 

RENC via email within 90 days of receiving the award.

(c) SMALL ENTITY FLEXIBILITY

There are no small entities affected because the respondents are states. 
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(d) COLLECTION SCHEDULE

Table 1

FORM SCHEDULE

Quality Assurance Reporting Form Due to RENC 90 days after award of grant

Semi-Annual Progress Report Form • Due to RENC April 30 (Oct. 1- Mar. 31 period)

• Due to RENC October 31 (Apr. 1 – Sept. 30 period)

• Final Due to the RENC 90 days after 

expiration/termination

6. BURDEN ESTIMATE AND COST OF COLLECTION

(a) ESTIMATING RESPONDENT BURDEN

The estimated hours for completing each form includes time for reviewing instructions, 

completing information and transmitting through email or via CDX.

Table 2

Form Estimated 

Hours

Frequency per 

Year

Total Burden 

Hours

Semi-Annual Progress Report Form 0.75 2 1.5

Quality Assurance Reporting Form 1 1 1

(b) RESPONDENT UNIVERSE AND BURDEN

At the beginning of fiscal year 2015, EPA estimates 200 grantees will be responding to 

the Semi-Annual Progress Report Form. That number is derived from an estimate of the rolling 

number of “active grants.” The number of active grants fluctuates throughout the year as projects 

are completed and grants are officially awarded and closed. Starting in FY 2013, every EN grant 

is awarded for a three-year project period (increased from two years). Including the grants that 

EPA awarded in FY 2014, open grants that have been extended, and grants still awaiting the 

submission or approval of technical reports, EPA estimates 200 Semi-Annual Progress Report 

Form respondents during any one given fiscal year.

The Quality Assurance Reporting Form will be completed once for each award by award 

recipients. These respondents are not unique; they are the same respondents who will submit 

Semi-Annual Progress Report Forms after the first six months of their projects. Of the 200 

respondents, it is anticipated that 40 of them will complete the quality assurance reporting form 

in addition to the semi-annual progress report forms. Assuming 40 new EN grant awards per 

year, EPA estimates 40 Quality Assurance Reporting Form respondents per fiscal year.

EPA’s burden estimate per year is based on the government’s fiscal year. In one fiscal 

year, a respondent who receives an award in 2014 will complete one quality assurance report and 

two semi-annual progress reports for that grant.
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Total Number of Responses:

Semi-Annual Progress Report Forms: 200 Respondents x 2 per year = 400

Quality Assurance Reporting Form: 40 Respondents x 1 per year = 40

Total = 440

Total Burden:

Semi-Annual Progress Report Forms: 200 Respondents x 1.5 hours = 300

Quality Assurance Reporting Form: 40 Respondents x 1 hour = 40

Total = 340

Table 3 summarizes respondent burden.

Table 3 – Respondent Burden

Respondents Calculation

Semi-Annual 

Progress 

Report Form

Quality 

Assurance 

Reporting 

Form

Total

a Estimated Hours per Form 0.75 1

b Frequency per Year 2 1

c

Annual Burden Hours per Form 

Type (a) x (b) 1.5 1

d Respondents per Year 200 40

e Responses per Year (b) x (d) 400 40 440

f Total Annual Burden Hours (c) x (d) 300 40 340

(c) ESTIMATING RESPONDENT COST

Respondent costs consist only of labor. There are no capital, operating and maintenance, or 

annualizing capital costs incurred by this information collection.

Respondent Wage Rate: $35.26 1x 1.50 = $52.88

Quality Assurance Reporting Form: 40 Total Annual Burden Hours x $52.88 = $2,115

Semi-Annual Progress Report Form: 300 Total Annual Burden Hours x $52.88 = 

$15,864

 

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$35.26 represents the average wage rate of several occupations expected to apply for grants or 

fellowships. 1.50 represents a 50% rate for benefits. $52.88 represents the average fully burdened wage 

rate, including benefits. These figures are derived from Table 3. State and local government, by major 

occupational and industry group: Management, Professional, and Related, found in the Bureau of Labor 

Statistics Economic News Release, “Employer Costs for Employee Compensation – September 2014.”
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Table 4 summarizes respondent costs.

Table 4 – Respondent Costs

Respondent Costs Semi-Annual

Quality 

Assurance Total

Labor Cost $15,864 $2,115 $17,979

Capital/Start-up Cost $0 $0 $0

Operating and Maintenance $0 $0 $0

Annualizing Capital $0 $0 $0

Total Costs $15,864 $2,115 $17,979

(d) ESTIMATING AGENCY BURDEN AND COST

To estimate the cost and burden to the RENCs, EPA assumes that each recipient will 

submit two Semi-Annual Progress Report Forms each year, and that each new grant recipient 

will submit one Quality Assurance Reporting Form each year. EPA assumes that there are 200

active grants in any single fiscal year, that 40 new grants are awarded each year, and that there is 

an even distribution for each (active and new grants) across all 10 regions. EPA estimates that it 

should take an RENC 0.5 hours to review/upload a Quality Assurance Reporting Form and 0.25 

hours to review/upload a Semi-Annual Progress Report Form. EPA estimates that each RENC 

will review (200/10) x 2 = 40 semi-annual forms and (40/10) x 1 = 4 quality assurance forms 

each year. Each RENC will spend 40 x 0.25 = 10 hours reviewing/uploading semi-annual forms 

and 4 x 0.5 = 2 hours reviewing quality assurance forms. The total number of hours that all of 

EPA’s RENCs review/upload forms is 10 x 10 = 100 hours for the Semi-Annual Progress Report 

Form and 2 x 10 = 20 hours for the Quality Assurance Reporting Forms, for a total of 120 hours 

each year. Assuming a fully burdened hourly rate of $55.99 2for each RENC, the cost to 

review/upload forms is 100 x $55.99 = $5,599 for Semi-Annual Progress Report Forms and 20 x 

$55.99 = $1,120 for Quality Assurance Reporting Forms, for a total of $6,719 each year. 

 

2 The 2015 average hourly rate for a General Schedule (GS) 13, Step 1 with Rest of U.S. Locality Pay ($39.99) was 

used to estimate burden costs for EPA’s RENCs. This rate was also fully burdened (x 40 %), yielding a wage rate of 

$55.99.
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Table 5 summarizes Agency burden.

Table 5 – Agency Burden

EPA RENCs Calculation

Semi-Annual 

Progress 

Report Form

Quality 

Assurance 

Reporting 

Form

Total

a

Estimated Hours per Form

(Review/Upload) 0.25 0.5

b Frequency per Year 2 1

c

Annual Burden Hours per Form 

Type (a) x (b) 0.5 0.5

d

Grants Subject to EPA 

Review/Upload per Year 200 40

e EPA Reviews/Uploads per Year (b) x (d) 400 40 440

f

Total Annual Burden Hours: 

EPA (c) x (d) 100 20 120

Table 6 summarizes Agency cost.

Table 6 – Agency Costs

EPA Costs Semi-Annual

Quality 

Assurance Total

Labor Cost $5,599 $1,120 $6,719

Capital/Start-up Cost $0 $0 $0

Operating and Maintenance $0 $0 $0

Annualizing Capital $0 $0 $0

Total Costs $5,599 $1,120 $6,719

(e) BOTTOM LINE BURDEN HOURS AND COSTS

Table 7 – Summary Burden Hours and Costs

Semi-Annual

Quality 

Assurance Total

Total Annual Responses 400 40 440*

Total Burden Hours for Respondents 300 hours 40 hours 340 hours

Total Burden Hours for EPA 100 hours 20 hours 120 hours

Total Respondent Cost $15,864 $2,115 $17,979

Total EPA Cost $5,599 $1,120 $6,719

Total Costs $21,463 $3,235 $24,698

*Not all respondents complete every activity, every year.
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(f) REASONS FOR CHANGE IN BURDEN

There is a decrease of 5 hours in the total estimated respondent burden compared with the 

ICR currently approved by OMB. This decrease is due to a decrease in the number of grants that 

are awarded annually. There is no change in respondent burden per response. Total estimated 

respondent cost has increased as a result of inflationary increases and updated methodologies for 

estimating respondent salaries.

Additionally, there is a decrease of 2.5 hours in the total estimated EPA burden. This 

decrease is due to a decrease in the number of grants that are awarded annually. There is no 

change in EPA burden per response. Total estimated EPA cost has increased as a result of

inflationary increases and updated methodologies for estimating EPA RENC salaries.

(g) BURDEN STATEMENT

The annual public reporting and recordkeeping burden for this collection of information 

is estimated to average .77 hours per response. Specifically, the estimate is 0.75 hours per 

response for the Semi-Annual Progress Report Form (total of 1.5 hours) and 1 hour per response 

for the Quality Assurance Reporting Form. Burden means the total time, effort, or financial 

resources expended by persons to generate, maintain, retain, or disclose or provide information 

to or for a Federal agency. This includes the time needed to review instructions; develop, 

acquire, install, and utilize technology and systems for the purposes of collecting, validating, and 

verifying information, processing and maintaining information, and disclosing and providing 

information; adjust the existing ways to comply with any previously applicable instructions and 

requirements; train personnel to be able to respond to a collection of information; search data 

sources; complete and review the collection of information; and transmit or otherwise disclose 

the information. An agency may not conduct or sponsor, and a person is not required to respond 

to, a collection of information unless it displays a currently valid OMB control number. The 

OMB control numbers for EPA's regulations are listed in 40 CFR part 9 and 48 CFR chapter 15. 

The burden for the Semi-Annual Progress Report Form is based on time for reviewing 

instructions, collecting the information and entering it into the form, and transmitting on-line (via 

CDX) or through email. For each Semi-Annual Progress Report Form, the respondent burden is 

0.75 hours. Respondents complete the form twice a year; thus the total annual burden is 1.5

hours. For the Quality Assurance Reporting Form, the annual respondent burden is 1 hour for 

each new EN grant awarded. 

To comment on the Agency's need for this information, the accuracy of the provided 

burden estimates, and any suggested methods for minimizing respondent burden, including the 

use of automated collection techniques, EPA has established a public docket for this ICR under 

Docket ID Number EPA-HQ-OEI-2006-0037, which is available for online viewing at 

www.regulations.gov, or in person viewing at the Office of Environmental Information Docket 

in the EPA Docket Center (EPA/DC), EPA West, Room 3334, 1301 Constitution Avenue, NW, 

Washington, D.C. The EPA Docket Center Public Reading Room is open from 8:30 a.m. to 4:30 

p.m., Monday through Friday, excluding legal holidays. The telephone number for the Reading 

Room is (202) 566-1744, and the telephone number for the Office of Environmental Information 
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Docket is (202) 566-1752. An electronic version of the public docket is available at 

www.regulations.gov. This site can be used to submit or view public comments, access the 

index listing of the contents of the public docket, and to access those documents in the public 

docket that are available electronically. When in the system, select “search,” then key in the 

Docket ID Number identified above. Also, you can send comments to the Office of Information 

and Regulatory Affairs, Office of Management and Budget, 725 17th Street, NW, Washington, 

D.C. 20503, Attention: Desk Officer for EPA. Please include the EPA Docket ID Number EPAHQ-OEI-2006-0037 and OMB Control Number 2025-0006 in any correspondence.
Exhibit A

OMB No. 2025-0006

Expires xx/xx/xxxx 

EPA Form 5300-26 1

U.S. ENVIRONMENTAL PROTECTION AGENCY

Exchange Network Grant Program Progress Report 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-September 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: 

Award Amount:

Expenditures during this reporting period:

Funds Remaining:

Reporting Period (starting and 

ending dates, mm/dd/yyyy): 

Date Report Submitted 

(mm/dd/yyyy): 

EPA Project Officer to Whom Report is Submitted: 

 

 Name: 

 

 EPA Region/Program:

Focus:
OMB No. 2025-0006

Expires xx/xx/xxxx 

EPA Form 5300-26 2

Progress Report Instructions:

1. List major goals and each goal’s outputs as described in the work plan

(Note for recipients submitting through CDX: After you have submitted your first online progress report for a grant, any changes to goals or 

outputs that are needed must be made by your EPA Regional Project Officer. You should submit your change request directly to your Regional 

Project Officer.) 

2. In the “Scheduled Completion Date” column, enter the dates from the grant work plan

3. In the “Actual Completion Date” column, enter the date each output completed as of the period covered by this report

4. In the “Progress and Status” field below each output, enter any factor that has or will affect the recipient’s ability to complete that output; also 

indicated whether a resource listed in RCS or ENDS was used or, if a resource was created, it was registered in ENDS or RCS.

EXAMPLE

Goals Tasks/Outputs Scheduled

Completion

Date

Actual 

Completion 

date

1. Flow ambient air quality data 

through the Exchange Network.

1. Develop XML schema mm/yyyy mm/yyyy

Progress and Status

2. Initiate first test data flow mm/yyyy

Progress and Status

Goals Tasks/Outputs Scheduled 

Completion 

Date

Actual 

Completion 

date

Progress and Status:
OMB No. 2025-0006

Expires xx/xx/xxxx 

EPA Form 5300-26 3

Goals Tasks/Outputs Scheduled 

Completion 

Date

Actual 

Completion 

date

Progress and Status:

Progress and Status:

Comments

Instructions: If you have had any problems during the current period please report them here. In accordance with 2 C.F.R. §200.328(d), a 

recipient of an EPA assistance agreement must notify EPA of any problems, delays, or adverse conditions. If you have had any project-level 

problems or delays in spending grant funds during the current period, please report them in this section.

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:

Paperwork Reduction Act (PRA) Burden Statement: The public reporting and recordkeeping burden for this collection of information is 

estimated to average forty-five 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 Director, 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.
Exhibit B OMB No. 2025-0006

Expires xx/xx/xxxx 

EPA Form 5300-27 1

U.S. ENVIRONMENTAL PROTECTION AGENCY

Quality Assurance Reporting Form

for Use by Recipients of Assistance Agreements

Recipient Organization: 

Name:

Address:

EPA Award Number:

Project/Program Period(starting and ending dates, mm/dd/yyyy):

Activity Group: 

(check all that apply)

□ Infrastructure Development

□ Data Exchange, Analysis and Integration

□ Planning, Mentoring, and Training

□ Challenge

Goal Task Output Outcome Quality Assurance Measures

Instructions: - Please submit electronically to your EPA Regional Project Officer within 90 days of award.

 - For Quality Assurance Measures, please refer to most recent Solicitation Notice for Quality Assurance Guidelines.

 - For Goals, please refer to goals outlined in your assistance agreement work plan.

Paperwork Reduction Act (PRA) Burden Statement: The public reporting and recordkeeping burden for this collection of information is estimated to average one hour 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 Director, 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.