Document ID: EPA-HQ-OEI-2006-0037-0002
Agency: epa
Document Type: Supporting & Related Material
Title: 
Posted Date: 2006-03-15T05:00Z

OMB
No.
2025­
0006
Expires
7/
31/
2006
EPA
Form
5300­
26
1
U.
S.
ENVIRONMENTAL
PROTECTION
AGENCY
Exchange
Network
Grant
Program
Progress
Reporting
Form
for
Use
by
Recipients
of
Assistance
Agreements
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
September
1­
March
3.
Fall
reports
are
due
to
the
regional
project
officer
by
October
31
for
the
period
April
1­
September
30.
EPA
Grant
Number
 
Program
Code,
Number,
and
Amendment
Number
(
e.
g.,
OS
 

12345678
 
0):

Recipient
Information:

Agency
Name:
For
grants
awarded
before
2006
Exchange
Network
Grant
Category
(
i.
e.,
One
Stop,

Readiness,
Implementation,
or
Challenge):

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):

Project
Manager:

Name:
Phone:

Email:
EPA
Project
Officer
to
Whom
Report
is
Submitted:

Name:

EPA
Region/
Program:

Focus:
OMB
No.
2025­
0006
Expires
7/
31/
2006
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
enhance
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
Completion
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
Enhanced
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
Completion
date
List
Outcomes
for
Each
Goal,
and,
if
they
differ,

each
Output
OMB
No.
2025­
0006
Expires
7/
31/
2006
EPA
Form
5300­
26
3
Goals
Outputs
Scheduled
Date
Completion
date
List
Outcomes
for
Each
Goal,
and,
if
they
differ,

each
Output
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
40
C.
F.
R.

§
31.40(
d),
a
recipient
of
an
EPA
assistance
agreement
must
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:
OMB
No.
2025­
0006
Expires
7/
31/
2006
EPA
Form
5300­
26
4
Definitions
 
Project/
Program
Goal:
A
major
objective
or
endpoint
identified
in
the
assistance
agreement
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
may
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)
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.