Form 6400-01 NPDES Permittee Data Report Form

PRE-SORTED
FIRST-CLASS MAIL
POSTAGE & FEES PAID
EPA
PERMIT NO. G-35

United States
Environmental Protection Agency
OECA MC 2227A
WASHINGTON DC 20460
———————————————
Official Business

TIME SENSITIVE – RESPONSE NEEDED
Mailroom: Please forward to responsible office.
IMPORTANT DATES TO REMEMBER
March 20, 2020:
April 24, 2020:
July 2, 2020:
August 28, 2020:
October 23, 2020:

DMR-QA Study 40 begins;
participants may begin ordering PT Samples
Submit address verification to DMR-QA Coordinator
DMR-QA Study 40 ends
Submit DMR-QA 40 Results to DMR-QA Coordinator
Submit corrective action reports and retest results
to DMR-QA Coordinator, if applicable

IMPORTANT NOTICE TO NPDES PERMITTEES
DMR-QA Study 40 Announcement

DMR-QA STUDY 40
Immediately verify receipt of DMR-QA Study 40 by either filling out the form below and mailing this page to your State
DMR-QA Coordinator (listed on pages 7-8) or follow the e-mail instructions at the bottom of this page.
The mailed form must be postmarked on or before April 24, 2020.
NPDES PERMITTEE ADDRESS VERIFICATION FORM
Discharge Monitoring Report - Quality Assurance (DMR-QA) Study 40
Please provide corrections to the mailing address where all DMR-QA study paperwork should be sent.

State

NPDES Permit Number

(2-character State Code + 7 digit Permit Code as shown on the mailing label, for
example AR1234567)

If contact/address information from the
mailing label or e-mail is correct, please check this box only →
Facility Name
Contact Name

Title

Mailing Address
City

State

Phone Number

Fax Number

Zip Code

E-mail Address

ELECTRONIC NOTIFICATION PROCEDURE
You may verify receipt electronically by sending an e-mail on or before April 24, 2020 to your State DMR-QA Coordinator
(listed on pages 7-8 of the enclosed instructions). The e-mail should be composed in the following manner:
1.
2.

Subject line should contain ONLY the NPDES Permit number (2-character State Code + 7-digit Permit Code as shown on the mailing
label, for example AR1234567).
If you require any changes to the mailing label on this announcement, the body of the e-mail should contain a list including:
Company name, Contact Name/Title, Mailing Address, City, State, Zip Code, Facility Type (select one: federal, state, local or
commercial/private). Otherwise, you may simply write “No changes to address or contact information” in the body of the e-mail.

UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
WASHINGTON, DC 20460

DRAFT (UNSIGNED)

OFFICE OF
ENFORCEMENT AND
COMPLIANCE ASSURANCE

Dear NPDES Permit Holder:
This letter initiates the 2020 Discharge Monitoring Report - Quality Assurance (DMR-QA) Study 40. By receipt of this
letter, you are required under Clean Water Act (CWA) Section 308 to participate in DMR-QA Study 40 unless your
facility is covered by an EPA waiver.1 Your participation plays a key role in monitoring the quality of data used to
assure the integrity of the CWA's National Pollutant Discharge Elimination System (NPDES), and, in turn, assures your
ability to maintain compliance with NPDES permit conditions.
DMR-QA Study 40 covers major and select minor NPDES permit holders. You (the permittee) are responsible for
ensuring that results of DMR-QA Study tests, performed by your in-house and/or contract laboratories, are graded by
an accredited Proficiency Testing (PT) Provider. If any graded results are "Not Acceptable," you must follow up with
the laboratory to determine the cause of the deficiency and ensure corrective action is taken to prevent future
occurrences. While performing tests and analyses, please ensure that your test methods/procedures follow 40 CFR
part 136 regulations and applicable guidance. Use the same personnel and equipment as you would for routine
NPDES permit compliance monitoring tests.
What changes were made to DMR-QA Study 40?
The schedule for DMR-QA Study 40 is slightly different compared to last year's study (Study 39). Please review the
DMR-QA Study 40 schedule on page 1.
Further information
Permittees with valid e-mail addresses will receive the DMR-QA Study by e-mail. You may request a hard copy from
EPA by sending an e-mail to [email protected]. Questions on the national program should be addressed to
Greg Savitske ([email protected], 202-564-2601), EPA's National DMR-QA Coordinator. State and EPA Regional DMR-QA
contact information is provided on pages 6-8. Please reference your NPDES permit number on all correspondence.
Thank you for your attention to this Clean Water Act Section 308 requirement.
Sincerely,

DRAFT (UNSIGNED)
Martha Segall, Acting Director
Monitoring, Assistance, and Media Programs Division
Office of Compliance
Enclosures

1 EPA is authorized to collect this information under Section 308 of the Clean Water Act, 33 U.S.C. § 1318. This information request is
enforceable under 33 U.S.C. § 1319. EPA may grant a waiver from participating in DMR-QA to states with laboratory quality assurance
programs approved by EPA as a substitute for the DMR-QA Study. Refer to the footnote on page 2 to determine if you are covered by an EPA
waiver, or contact your State DMR-QA Coordinator.

Internet Address (URL) · http://www.epa.gov

DMR-QA Study 40
Table of Contents and Schedule
DMR-QA Study 40 Frequently Asked Questions
NPDES Permittee Instructions
Chemistry/Microbiology Laboratory Instructions
WET Testing Laboratory Instructions
Accredited Proficiency Testing Providers
EPA Regional and State DMR-QA Coordinators
NPDES Permittee Data Report Form
Chemistry/Microbiology Analyte Checklist
WET Analyte Checklist

2
3
4
5
6
6
9
12
13

Checklist and Schedule for DMR-QA Study 40
Permittee

Deadline*
March 20, 2020

April 24, 2020

July 2, 2020

In-House and Contract Laboratories

Study 40 begins

Study 40 begins

Notify all laboratories of DMR-QA Study 40

Order test samples from PT Provider. If using WP
study to satisfy DMR-QA requirements, specify
that to PT Provider when ordering test samples.

PT Providers

Send Address Verification Form (inside cover of
this package) to the State DMR-QA Coordinator
by e-mail or postal mail to confirm receipt of
Study 40 Announcement
Study 40 ends

Study 40 ends

Study 40 ends

Send ungraded Data Report to PT Providers
(include a list of all NPDES permits using your
laboratory data)
Send PT Provider-graded test
results, for each permit (listed by
NPDES permit numbers), to:
- Laboratory
- State DMR-QA coordinators

July 31, 2020

August 14, 2020

August 28, 2020

October 23,
2020

After receipt of PT Provider-graded results,
ensure laboratories perform retests for any
analytes graded "Not Acceptable"

Send one signed copy of the NPDES
Permittee Data Report Form, copies of the
PT Provider-graded test results, and copies
of the Chemistry/Microbiology and WET
Checklists for each laboratory used, to the
State DMR-QA Coordinator

Forward PT Provider-graded test results to the
Permittee
Order retest samples from PT Provider for all
"Not Acceptable" analyte test results. If using a
WP study to satisfy corrective action, data must be
reported to the PT Provider by the published
WP study close date, even if it is prior to the
DMR-QA deadline of October 23, 2020.

Send corrective action letter including any
retest results as soon as possible to your
Permittee, if applicable.

Submit corrective action report including
retest results to the State DMR-QA
Coordinator, if applicable

* All materials must be sent on or before the date provided.
Page 1

DMR-QA STUDY 40 - Frequently Asked Questions
Am I required to participate in this Discharge Monitoring Report - Quality Assurance (DMR-QA) Study?
NPDES Major and select Minor permit holders are required to participate in the DMR-QA studies. Be sure to verify the NPDES permit
number on the front of this package or indicated in your e-mail. If you believe you received this study in error, contact your State
DMR-QA Coordinator (pages 7-8). Some permit holders are not required to perform the DMR-QA study because they are located in a
state that has a laboratory quality assurance program approved by EPA as a substitute for DMR-QA.2
What is the purpose of this DMR-QA Study?
The purpose of DMR-QA Study 40 is to ensure the integrity of data submitted by the permittee for DMR reporting requirements and
evaluate performance of the laboratories to analyze wastewater samples.
What laboratory tests are required under DMR-QA?
Permittees are responsible for having their laboratory(ies) test wastewater analytes that are both in their NPDES permit and included
in Study 40. For required Whole Effluent Toxicity (WET) tests, permittees must participate even if the test conditions (e.g., temperature,
time of acute test, synthetic seawater matrix, etc.) in the permit do not exactly match those in Study 40. Refer to "WET Testing
Laboratory Instructions" (page 5) for more information.
How should laboratory personnel perform DMR-QA tests?
For all pollutant parameters, especially field test parameters (e.g., pH, residual chlorine), use the same personnel and equipment as
required for NPDES permit compliance monitoring tests. Ensure your test methods and procedures follow 40 CFR part 136 regulations.
Where can laboratories get test samples?
Laboratories may order DMR-QA samples from a Proficiency Test (PT) Provider accredited by the American Association for Laboratory
Accreditation (A2LA) or the ANSI National Accreditation Board (ANAB). A list of accredited PT Providers is provided on page 6.
What should permittees and laboratories do first?
Permittees must first confirm receipt of this package by April 24, 2020 to their State DMR-QA Coordinator (pages 6-8) via e-mail or
postal mail. Permittees must also send a copy of the enclosed instructions/checklists to all in-house and contract laboratories. The
permittee specifies on the checklist which analyses the laboratory will perform. See Permittee Instructions (page 3) for more
information. Upon receipt of instructions, laboratories must order samples from an accredited PT Provider (page 6). This should be
done early to allow sufficient time to perform the required analyses and send ungraded results to the PT Provider prior to the close of
DMR-QA Study 40 (July 2, 2020). See Laboratory Instructions (pages 4-5) for more information.
Can I use a Water Pollution (WP) Study to satisfy DMR-QA requirements?
Yes, permittees may use a WP study to satisfy some or all of the DMR-QA requirements. However, only results from WP studies closing
between January 1 and July 2, 2020 will be accepted. See Permittee Instructions for more information (Step 5 on page 3).
What steps do I take after the proficiency testing?
After laboratories report their data to the PT Providers, the PT Provider issues a report to the laboratory and the State DMR-QA
Coordinator, indicating the results were "Acceptable" or "Not Acceptable." The laboratory must then forward a copy of the graded
report to the permittee. The permittee subsequently completes the checklists on pages 12-13, indicating the laboratory's grade for
each required analyte. One set of checklists must be used for each laboratory. The permittee must also fill out the NPDES Permittee
Data Report Form (EPA Form 6400-01, pages 9-11) and submit a signed copy with the completed checklists and copies of the
laboratory's graded reports to the State DMR-QA Coordinator by August 28, 2020.
What do I do if a laboratory receives a "Not Acceptable" result?
If any graded results are "Not Acceptable," the permittee must follow up with the laboratory to determine the cause of the result and
take corrective action to prevent future occurrences. The laboratory must order retesting samples, analyze them, and write a
corrective action response for the permittee. The permittee then submits retest results and a corrective action report to the State
DMR-QA Coordinator by October 23, 2020. Note: If using a WP study to satisfy corrective action, data must be reported to the PT
Provider by the published WP study close date, even if it is prior to the DMR-QA deadline of October 23, 2020.
Where do I go for more information?
DMR-QA resources including fill-and-print forms are available at https://www.epa.gov/compliance/discharge-monitoring-reportquality-assurance-study-program.
2 As of March 1, 2020, permittees in the following states have laboratory quality assurance programs approved by EPA as a substitute for DMR-QA

Study 40: CA, KS, KY, NJ, NV, NC, PA, SC, UT, VA, WV and WI. Louisiana has an approved laboratory quality assurance program for commercial
laboratories only. NPDES permittees in Arkansas, Maine, New Hampshire and Oklahoma that are covered by their State laboratory accreditation
program are also exempted from DMR-QA Study 40. Laboratories in Arkansas, Maine, New Hampshire, and Oklahoma not fully certified by the State
must perform DMR-QA studies. Check with your State DMR-QA Coordinator if you have questions about your state's waiver status.

Page 2

NPDES Permittee Instructions
1.

Verify your participation in DMR-QA Study 40 by confirming the NPDES permit number on the front of this package or in e-mail. If you
believe you received this study in error or have questions about your exemption status, contact your State DMR-QA Coordinator
(pages 7-8). Please refer to Footnote 2 of the Frequently Asked Questions page (page 2) for a list of exempted states.

2. Follow the instructions on the DMR-QA Study 40 Important Notice (inside front cover of study package) and immediately confirm
receipt of this package to your State DMR-QA Coordinator via postal mail or e-mail. You must submit your response no later than
April 24, 2020. If your permit is inactive, please contact your State DMR-QA Coordinator immediately.
3.

Send copies of these instructions to each contract and in-house laboratory, if applicable. Ensure DMR-QA samples are analyzed by the
same laboratories that routinely perform analyses for your Discharge Monitoring Report (DMR) requirements. Indicate which tests the
laboratory will perform by checking the appropriate boxes in the "Test Required" column in the enclosed tables (pages 12-13).

4.

Ensure that each laboratory uses their U.S. EPA Laboratory Code on all reported results. Make certain your laboratories understand
and complete all requirements. Laboratories needing a new U.S. EPA Lab Code or wanting to confirm their existing U.S. EPA Lab Code,
should contact their EPA Regional DMR-QA Coordinator listed on page 6. Submit all requests for lab codes at least one week before
the DMR-QA Study 40 end date (July 2, 2020) or one week prior to the PT Provider's WP study due date to allow time for response.

5.

Instruct your laboratory to order samples for analytes that are both in your permit and included in DMR-QA Study 40. Your in-house
and contract laboratories must order PT samples from an accredited PT Provider (page 6). Ensure your laboratory orders the samples
early enough to allow time to perform the required analyses and send results to the PT Provider prior to the close of DMR-QA
Study 40 (July 2, 2020). Your laboratory should register your permit number with the PT Provider prior to July 2, 2020. Note: If your
in-house or contract laboratory chooses to use a WP study to satisfy DMR-QA requirements, please inform the laboratory that all data
must be reported to the PT Provider by the published WP study close date, even if it is prior to the DMR-QA deadline of July 2, 2020.
WP studies are only valid for DMR-QA Study 40 if the WP study meets the following requirements:
a) Samples are offered by an accredited PT Provider (page 6).
b) The WP study does not close before January 1, 2020, or after July 2, 2020.
c) The PT Provider shows the WP results from each of the permittee's regulated analytes on the DMR-QA reporting form.

6.

Permittees are responsible for ensuring that laboratories submit data on permittee's behalf to the PT Provider by the end of DMR-QA
Study 40 (July 2, 2020). Laboratories must send ungraded data to the same PT Provider they received samples from. By July 31,
2020, PT Provider-graded test results will be sent back to the laboratories. Permittees will not receive graded reports directly from PT
Providers unless they are an in-house laboratory. Note: Permittees are not required to report ungraded data to the PT Provider on
their laboratories' behalf nor should permittees send ungraded data to their State DMR-QA Coordinator.

7.

Permittees must require laboratories to forward to them graded results from the PT Provider by August 14, 2020. Using these graded
results, permittees must fill out the Chemistry/Microbiology Analyte and WET Analyte checklists (pages 12-13) for each laboratory,
indicating the analyte tests performed by the laboratory and whether the result was Acceptable or Not Acceptable. Make sure the
appropriate NPDES permit number and U.S. EPA Lab Code are on each checklist. If you use more than one laboratory, you must use a
separate checklist for each laboratory. If a laboratory reports more than one method to you for any single analyte, you must use a
separate checklist for each method reported.

8.

Follow the directions on the "NPDES Permittee Data Report Form" (Form 6400-01, pages 9-11) and complete the information. You
may use a "fill and print" form available at: https://www.epa.gov/compliance/discharge-monitoring-report-quality-assurance-studyprogram. By August 28, 2020, you must send a copy of the signed Form 6400-01, graded results, and completed checklists from
step 7 for each of your permits to the State DMR-QA Coordinator.
a)

However, if you (the Permittee) have verified that the PT Provider's graded results have been transmitted to the State DMR-QA
Coordinator, the permittee is only required to submit Form 6400-01 and the applicable checklists to the State DMR-QA
Coordinator. In this situation, the laboratory should provide a list of its permittees' permit numbers associated with each required
analyte to the PT Provider prior to the close of DMR-QA Study 40 or the WP study. Check with your laboratory to determine
whether the PT Provider is sending the graded data directly to the State DMR-QA Coordinator.
b) Permittees must maintain a copy of the completed NPDES Permittee Data Report Form, checklists and graded laboratory results
as a record for at least three (3) years.
9.

After receiving laboratory results, permittees must consult with the laboratory and investigate any discrepancies or "Not Acceptable"
evaluations reported by the PT Provider. Permittees must identify, and report to the State DMR-QA Coordinator, causes and system
changes to correct the discrepancies. Laboratories must order retesting samples by August 14, 2020 for any "Not Acceptable" results
and perform the retests as soon as possible. The Corrective Action report should include results from any retest/verification analysis
performed and must be sent to the State DMR-QA Coordinator before October 23, 2020.

Page 3

Chemistry/Microbiology Laboratory Instructions
Your laboratory is designated to participate in DMR-QA Study 40 by a NPDES permittee because the permittee uses or plans to use
your laboratory to perform chemistry/microbiology analyses to satisfy their NPDES permit requirements during 2020. For
measurements of all pollutant parameters, especially field test parameters (pH, residual chlorine, etc.), use the same personnel and
equipment as required for NPDES compliance monitoring analyses. Please ensure that your test methods/procedures follow 40 CFR
part 136 regulations. Please note that for low level mercury, the concentration range is 20 - 100 ng/L (20 - 100 parts per trillion) and
for low level total residual chlorine, the concentration range is 75 - 250 μg/L (75 - 250 parts per billion). If you have questions about
whether you should perform the test using the normal or the low level mercury and/or low level total residual chlorine concentration,
contact your State DMR-QA Coordinator.
1.

Each permittee for whom you analyze or provide data in 2020 will determine which analyses you must perform by checking the
appropriate boxes on the enclosed "Chemistry/Microbiology Analyte Checklist" (page 12).

2. Order DMR-QA Study 40 chemistry and microbiology samples from one of the Proficiency Test (PT) Providers (page 6). Be sure to
allow yourself enough time to perform the analyses before the closing date of DMR-QA Study 40 (July 2, 2020). Maintain a copy
of all completed order forms for your records.
Note: You may be able to utilize the results from a Water Pollution (WP) study to meet the requirements of DMR-QA, if all of
the following conditions are met:
a) Samples are offered by an accredited PT Provider (page 6).
b) The WP study does not close before January 1, 2020, or after July 2, 2020.
c) The PT Provider shows the WP study results of each permittee's regulated analytes on the DMR-QA reporting form.

3. Record your ungraded analytical data and your EPA Lab Code on the Data Reporting Forms received with your samples. Be sure to
follow the PT Provider's instructions and deadlines received with these samples.
4. Use of the EPA-assigned Lab Code on all reported results is required. If you need a new EPA Lab Code or need to verify your
existing EPA Lab Code, please contact your EPA Regional DMR-QA Coordinator (see contact information on page 6).
5.

Send the data requested by each of your permittees to the PT Provider for grading. You must send data to the same PT Provider
that you received samples from. Make sure you provide the DMR-QA Study 40 or WP study results to the PT Provider by July 2,
2020. If you choose to use a WP study, you must report all data to the PT Provider by their published WP study close date, even if
it is prior to the DMR-QA deadline of July 2, 2020. Notify the PT Provider that the WP study is being used to satisfy DMR-QA
requirements, and send them copies of the analyte checklist(s) if you are reporting via hard copy.

6. The PT Provider will grade your analyses and send the graded results to you by July 31, 2020. If the PT Provider is submitting
graded results sorted by permit number to the State DMR-QA Coordinator, then you should register your permittees' permit
numbers associated with each required analyte with the PT Provider prior to the close of DMR-QA Study 40 or the WP study.
Forward the graded results of the analytes to the permittee by August 14, 2020, so the permittee can fill out the analyte
checklist on page 12.
7. If any graded results are "Not Acceptable," laboratories should coordinate with the permittee to determine the cause of the result
and identify corrective action to prevent future occurrences. Laboratories must order retest samples for "Not Acceptable" analyte
test results by August 14, 2020. The corrective action report and graded retest results must be forwarded to the permittee as
soon as possible, but no later than October 23, 2020.

Page 4

WET Testing Laboratory Instructions
Your laboratory is designated to participate in DMR-QA Study 40 by a NPDES permittee because the permittee uses or plans to use your
laboratory to perform Whole Effluent Toxicity (WET) analyses during 2020. For all analytes, use the same personnel and equipment as
required for NPDES permit compliance monitoring analyses. Labs should ensure that WET test methods/procedures follow instructions
from your PT Provider and EPA's WET test manuals referenced below, which include both EPA's promulgated WET test methods at
40 CFR part 136 and EPA's recommended West Coast WET test methods.
1.

The permittee(s) determine which analyses you will perform by checking the appropriate boxes on the enclosed WET Analyte
checklist (page 13). Labs should ensure that the permittee has selected the test organism(s) and testing conditions that most
closely resemble those required by the permit for which you are supplying test results. Use the guidelines immediately below and
the table on page 13 to select the proper WET tests.
Guidelines for Choosing the Correct WET Test Organism/Conditions/Endpoint(s)
• Laboratories should only report one endpoint for each DMR-QA WET test code required.
• For laboratory performance quality assurance (QA) purposes only, the point estimation techniques that produce endpoints such as the
Inhibiting Concentration 25% (IC25) are the preferred statistical methods in calculating endpoints for effluent chronic toxicity tests. However,
laboratories should choose the statistical methods that allow calculation of the endpoint(s) required by the NPDES permit and are used for
routine permit compliance tests. For example, if the permit specifies a No Observable Effect Concentration (NOEC) endpoint for Survival and it
is reported regularly on DMRs, this endpoint may be reported for DMR-QA.
• If the permit requires WET testing with Fathead minnow (Pimephales promelas), Ceriodaphnia dubia, Daphnia magna, Daphnia pulex,
Americamysis bahia (Mysidopsis bahia), Inland silverside (Menidia beryllina) or Sheepshead minnow (Cyprinodon variegatus), test those
organisms listed in each permit using the test conditions, including temperature, defined in the WET Test Codes.
• If the permit's WET testing conditions for Ceriodaphnia dubia specify 48-hr acute static renewal testing, conduct this test using the static nonrenewal conditions specified in WET Test Codes 19 and 20.
• If the permit's WET testing conditions for Daphnia magna and Daphnia pulex specify 48-hr acute static renewal testing, conduct this test using
the static non-renewal conditions specified in WET Test Codes 32 and 38.
• If the permit's WET testing conditions require 24-, 48-, or 96-hr acute testing using any of the organisms included in Study 40, use the 48-hr
acute test conditions specified in the WET Test Codes.
• If the permit requires 20°C acute testing for any organisms included in Study 40, use 25°C acute test conditions specified in the WET Test Codes.

2.

Order DMR-QA toxicity samples from an accredited PT Provider (page 6). Allow yourself enough time to perform the analyses
before the closing date of DMR-QA Study 40 (July 2, 2020). Maintain a copy of all completed order forms for your records.

3.

Record your ungraded analytical data and EPA Lab Code number on the Data Report Form received with your samples. Be sure to
follow the PT Provider's instructions and deadlines received with the samples. You must use the EPA-assigned Lab Code on all
reported results. If you need a new EPA Lab Code or to verify your current code, contact your EPA Regional DMR-QA Coordinator
(page 6).

4.

Send the ungraded data requested by each of your permittees to the PT Provider for grading. You must send it to the same PT
Provider that you received samples from. Make sure you provide the DMR-QA Study 40 study results by July 2, 2020.

5.

The PT Provider will grade your results and send them to you by July 31, 2020. If the PT Provider is submitting graded results
sorted by permit number to the State DMR-QA Coordinator, then you should register your permittees' permit numbers associated
with each required analyte with the PT Provider prior to the close of DMR-QA Study 40 or the WP study. Forward the graded results
of the analytes to the permittee by August 14, 2020 so the permittee can fill out the analyte checklist on page 13.

6.

If any graded results are "Not Acceptable," laboratories should coordinate with the permittee to determine the cause of the result
and identify corrective action to prevent future occurrences. Laboratories must order retest samples for "Not Acceptable" analyte
test results by August 14, 2020. The corrective action report and graded retest results must be forwarded to the permittee as soon
as possible, but no later than October 23, 2020.

Reference Manuals: (see http://www.epa.gov/cwa-methods/whole-effluent-toxicity-methods)
1. Methods for Measuring the Acute Toxicity of Effluents to Freshwater and Marine Organisms, Fifth Edition, October 2002. U.S. Environmental
Protection Agency, Office of Water, Washington, DC, EPA 821-R-02-012.
2. Short-term Methods for Estimating the Chronic Toxicity of Effluents and Receiving Waters to Freshwater Organisms, Fourth Edition, October 2002. U.S.
Environmental Protection Agency, Office of Water, Washington, DC, EPA 821-R-02-013.
3. Short-term Methods for Estimating the Chronic Toxicity of Effluents and Receiving Waters to Marine and Estuarine Organisms, Third Edition, October
2002. U.S. Environmental Protection Agency, Office of Water, Washington, DC, EPA 821-R-02-014.
4. Method Guidance and Recommendations for Whole Effluent Toxicity (WET) Testing (40 CFR Part 136). July, 2000. U.S. Environmental Protection
Agency, Office of Water, Washington, DC, EPA-821-B -00-004.
5. Short-term Methods for Estimating the Chronic Toxicity of Effluents and Receiving Waters to West Coast Marine and Estuarine Organisms, 1st Ed.,
1995, U.S. Environmental Protection Agency, Office of Research and Development, Cincinnati, OH, EPA/600/R-95/136. http://cfpub.epa.gov/si/
si_public_record_report.cfm?dirEntryId=46584.

Page 5

Accredited Proficiency Testing Providers
The following Proficiency Test (PT) Providers are accredited by A2LA or ANAB. A2LA and ANAB have each been designated a
Proficiency Testing Oversight Body (PTOB)/Proficiency Testing Provider Accreditor (PTPA) by The NELAC Institute (TNI). Find the following
PT Providers on the internet at: http://www.nelac-institute.org/content/NEPTP/ptproviders.php.

NELAC-Accredited Provider

Chem

Micro

WET

Absolute Standards, Inc., Hamden, CT
Mr. Stephen Arpie (203) 281-2917 or (800) 368-1131
[email protected]

www.absolutestandards.com

X

X

Advanced Analytical Solutions, LLC, Parkersburg, WV
Fred Anderson (304) 485-6325
[email protected]

www.advancedqa.com

X

X

www.eraqc.com

X

X

X

www.sigmaaldrich.com/pt

X

X

X

New York State Department of Health Wadsworth Center, Albany, NY
Dr. Patrick Parsons (518) 474-7161
[email protected]
www.wadsworth.org/programs/ehs/pt

X

X

NSI Lab Solutions, Raleigh, NC
Mr. Mark Hammersla (800) 234-7837
[email protected]

www.nsilabsolutions.com

X

X

www.phenova.com

X

X

Environmental Resource Associates (ERA), Golden, CO
(800) 372-0122
[email protected]; [email protected]
MilliporeSigma, Laramie, WY
(800) 576-5690
[email protected]

Phenova Inc., Golden, CO
(866) 942-2978
[email protected]

EPA Regional DMR-QA Coordinators
EPA Region 1
(CT, MA, ME, NH, RI, VT)
Denny Dart
U.S. EPA Region 1
ECAD/ECAB/WCS
5 Post Office Square (Mail Code 04-4)
Boston, MA 02109-3912
(617) 918-1850
[email protected]

EPA Region 4
(AL, FL, GA, KY, MS, NC, SC, TN)
Jeffrey Wilmoth
U.S. EPA Region IV
LSASD/QAPSB/QAS
980 College Station Rd
Athens, GA 30605-2720
(706) 355-8623
[email protected]

EPA Region 2 (NJ, NY, PR, VI)
Lampros E. Bourodimos, PhD, PE
U.S. EPA Region II
LSASD/MAB/MOS
2890 Woodbridge Ave (MS 220)
Edison, NJ 08837
(732) 321-6704
[email protected]

EPA Region 5 (IL, IN, MI, MN, OH, WI)
Kenneth Gunter
U.S. EPA Region V
ECAD/WECAB/WS1
77 W. Jackson Blvd (ECW-15J)
Chicago, IL 60604
(312) 353-9076
[email protected]

EPA Region 3 (DC, DE, MD, PA, VA, WV)
Peter Gold
U.S. EPA Region III
ECAD/WB/NPDES
1650 Arch St (3ED32)
Philadelphia, PA 19103
(215) 814-5236
[email protected]

EPA Region 6 (AR, LA, NM, OK, TX)
Magda Dallemagne
U.S. EPA Region VI
ECAD/WTREB/WRS
1201 Elm St, Suite 500 (ECDWR)
Dallas, TX 75270
(214) 665-7396
[email protected]

EPA Region 7 (IA, KS, MO, NE)
Bryant C. Harris
U.S. EPA Region VII
ECAD/WB
11201 Renner Blvd
Lenexa, KS 66219
(913) 551-7770
[email protected]
EPA Region 8 (CO, MT, ND, SD, UT, WY)
Michael Boeglin
U.S. EPA Region VIII
ECAD/WEB/NWES
1595 Wynkoop St (8ENF-WNW)
Denver, CO 80202
(303) 312-6250
[email protected]

EPA Region 9
(AS, AZ, CA, GU, HI, MP, NN, NV)
Liliana Christophe
U.S. EPA Region IX
ECAD/AWAB/DSS
75 Hawthorne St (ENF-2-3)
San Francisco, CA 94105
(415) 972-3502
[email protected]
EPA Region 10 (AK, ID, OR, WA)
Robert Grandinetti
U.S. EPA Region X
ECAD/WEFB/SWES
825 Jadwin Ave, Suite 210
Richland, WA 99352
(509) 376-3748
[email protected]

Trying to find your
State DMR-QA Coordinator?
Turn to pages 7 and 8 →
Page 6

X

State DMR-QA Coordinators
Alabama
Sharon Moses
Alabama DEM
1350 Coliseum Boulevard
Montgomery, AL 36110
(334) 394-4355
[email protected]
Alaska
John Clark
Alaska DEC - Division of Water
555 Cordova St
Anchorage, AK 99501-2617
(907) 269-3066
[email protected]
American Samoa
Liliana Christophe
U.S. EPA Region IX
ECAD/AWAB/DSS
75 Hawthorne St (ENF-2-3)
San Francisco, CA 94105
(415) 972-3502
[email protected]
Arizona
Michael Tenczar
AZPDES Individual Permits Unit
Arizona Dept of Environmental Quality
1110 W. Washington St
Phoenix, AZ 85007
(602) 771-4623
[email protected]
Arkansas*
Penny Semberski
Arkansas Department of
Energy and Environment
5301 Northshore Drive
North Little Rock, AR 72118
(501) 682-0941
[email protected]
California*
Melissa Morris
Office of Information Mgmt & Analysis
State Water Resources Control Board
1001 I Street, 16-39DSacramento, CA 95814
P.O. Box 100- Sacramento, CA 95812
(916) 341-5583
[email protected]
Colorado
Aly Ulibarri
Colorado Dept. of Public Health and
Environment
Water Quality Control Division-CWE-B2
4300 S Cherry Creek Drive South
Denver, CO 80246
303-692-3163
[email protected]
Connecticut
Donald Gonyea
Connecticut DEEP
Bureau of Materials Management and
Compliance Assurance
79 Elm Street
Hartford, CT 06106
(860) 424-3827
[email protected]

Delaware
Nicole Smith
Delaware DNREC - Division of Water
Surface Water Discharges Section
89 Kings Hwy - R and R Building
Dover, DE 19901
(302) 739-9946
[email protected]

Indiana
Becky Ruark
Indiana DEM/Office of Water Quality
100 North Senate Avenue
MC 65-42, IGCN N1255
Indianapolis, IN 46204-2251
(317) 691-1909
[email protected]

District of Columbia
Joshua Rodriguez
District of Columbia Department of
Environment - Water Quality Division
1200 First Street NE, 5th Floor
Washington, DC 20002
(202) 535-2226
[email protected]

Iowa
Bryant C. Harris
U.S. EPA Region VII
ECAD/WB
11201 Renner Blvd
Lenexa, KS 66219
(913) 551-7770
[email protected]

Florida
William Joyner
U.S. EPA Region IV, ECAD/WEB/DWWS
61 Forsyth St SW, MC-9T25
Atlanta, GA 30303-8960
(404) 562-8975
[email protected]

Kansas*
Paul Harrison
Kansas Dept. of Health & Environment
Kansas Health and Environmental
Laboratories
6810 SE Dwight Street
Topeka, KS 66620
(785) 296-6198
[email protected]

Georgia
Marzieh Shahbazaz
Georgia DNR
Environmental Protection Division
Watershed Protection Branch
2 MLK Jr. Dr., S.W., Suite 1152 East
Atlanta, GA 30334
(404) 463-4933
[email protected]
Guam
Maricar Quezon
Water Pollution Control Program
Guam EPA
P.O. Box 22439
Barrigada, GU 96921
(671) 475-1601
[email protected]
Hawaii
Scott Miyashiro
Hawaii Department of Health
Clean Water Branch
919 Ala Moana Boulevard, Room 301
Honolulu, HI 96814-4920
(808) 586-4309
[email protected]
Idaho
Robert Grandinetti
U.S. EPA Region X
ECAD/WEFB/SWES
825 Jadwin Avenue, Suite 210
Richland, WA 99352
(509) 376-3748
[email protected]
Illinois
Michelle Rousey
Illinois EPA
Bureau of Water
1021 North Grand Avenue East
P.O. Box 19276 (Mail Code 15)
Springfield, IL 62794-9276
(217) 785-3944
[email protected]

Michigan
Chris Veldkamp
Michigan EGLE
Water Resources Division
State of Michigan Building
350 Ottawa Ave NW, Unit 10
Grand Rapids, MI 49503
(616) 401-1556
[email protected]
Minnesota
Sarah Yost
Minnesota Pollution Control Agency
Environmental Outcomes Division
520 Lafayette Road
St. Paul, MN 55155
(651) 757-2810
[email protected]
Mississippi
Erica Scarbrough
Mississippi DEQ
Office of Pollution Control
1542 Old Whitfield Road
Pearl, MS 39208
(601) 961-5778
[email protected]

Kentucky*
Patrick J. Garrity
Laboratory Certification Officer
Kentucky DEP - Division of Water
300 Sower Blvd, 3rd Floor
Frankfort, KY 40601
(502) 782-6954
[email protected]

Missouri
Bryant C. Harris
U.S. EPA Region VII
ECAD/WB
11201 Renner Blvd
Lenexa, KS 66219
(913) 551-7770
[email protected]

Louisiana*
Sandy Coon
Louisiana DEQ
Office of Environmental Compliance
P.O. Box 4312
Baton Rouge, LA 70821-4312
(225) 219-3614
[email protected]

Montana
Gina Self
Montana DEQ
Water Protection Bureau
P.O. Box 200901
Helena, MT 59620-0901
(406) 444-5388
[email protected]

Maine*
Judy Bruenjes
Maine Dept. of Environmental Protection
Division of Water Quality Management
17 State House Station
Augusta, ME 04333
(207) 287-7806
[email protected]

Nebraska
Reuel Anderson
Nebraska DEQ
Water Quality Division
P.O. Box 98922
Lincoln, NE 68509
(402) 471-1367
[email protected]

Maryland
Ron Wicks
Maryland Dept. of the Environment
Water Management Administration
Compliance Program
1800 Washington Blvd, Suite 420
Baltimore, MD 21230
(410) 537-3607
[email protected]

Nevada*
Donald E. LaFara
Bureau of Safe Drinking Water
Nevada Division of Environmental
Protection
901 S. Stewart Street, Suite 4001
Carson City, NV 89701
(775) 687-9491
[email protected]

Massachusetts
Ping Yee
Massachusetts DEP/Boston Office
1 Winter Street, 5th Floor
Boston, MA 02108
(617) 292-5769
[email protected]

Page 7

(List continues on next page →)

New Hampshire*
Stephanie Larson
New Hampshire DES - Water Division
P.O. Box 95
Concord, NH 03302-0095
(603) 271-1493
[email protected]
New Jersey*
Lampros E. Bourodimos, PhD, PE
U.S. EPA Region II, LSASD/MAB/MOS
2890 Woodbridge Ave (MS 220)
Edison, NJ 08837
(732) 321-6704
[email protected]
New Mexico
Barbara Cooney
New Mexico Environment Department
Surface Water Quality Bureau
Harold Runnels Bldg, N 2050
1190 South St. Francis Drive (8750S)
P.O. Box 5469
Santa Fe, NM 87505-5469
(505) 827-0212
[email protected]
New York
Lampros E. Bourodimos, PhD, PE
U.S. EPA Region II, LSASD/MAB/MOS
2890 Woodbridge Ave (MS 220)
Edison, NJ 08837
(732) 321-6704
[email protected]
North Carolina*
Dana Satterwhite
North Carolina DEQ
Water Sciences Section
Laboratory Certification Branch
1623 Mail Service Center
Raleigh, NC 27699-1623
(919) 733-3908 ext. 202
[email protected]
North Dakota
Marty Haroldson
North Dakota DEQ
Division of Water Quality
Permits Program
918 East Divide Ave., 4th Floor
Bismarck, ND 58501
(701) 328-5234
[email protected]

Northern Mariana Islands
Liliana Christophe
U.S. EPA Region IX
ECAD/AWAB/DSS
75 Hawthorne St (ENF-2-3)
San Francisco, CA 94105
(415) 972-3502
[email protected]

Rhode Island
Matthew Puglia, PE
Rhode Island DEM
Office of Water Resources
235 Promenade Street
Providence, RI 02908
(401) 222-4700 x7131
[email protected]

Vermont
Amy Polaczyk
Vermont Dept. of Environmental
Conservation
1 National Life Dr. - Bldg Main 2
Montpelier, VT 05620-3522
(802) 490-6185
[email protected]

Ohio
Steve Roberts
Ohio EPA
8955 East Main Street
Reynoldsburg, OH 43068
(614) 644-4225
[email protected]

South Carolina*
Paul Miller
Office of Environmental Lab Certification
SC DHEC Bureau of Environmental Services
2600 Bull St
Columbia, SC 29201
(803) 896-0971
[email protected]

Virgin Islands
Lampros E. Bourodimos, PhD, PE
U.S. EPA Region II, LSASD/MAB/MOS
2890 Woodbridge Ave (MS 220)
Edison, NJ 08837
(732) 321-6704
[email protected]

Oklahoma*
Lynzie Chan
Oklahoma DEQ
P.O. Box 1677
Oklahoma City, OK 73101
(405) 702-8243
[email protected]
Oregon
Aliana Britson, PhD
Oregon DEQ
Laboratory & Environmental Assurance
Division
7202 NE Evergreen Pkwy, Suite 150
Hillsboro, OR 97124
(503) 693-5773
[email protected]

South Dakota
Tim Flor
South Dakota Dept of Environment &
Natural Resources
Surface Water Quality Program
523 East Capital
Pierre, SD 57501
(605) 773-3351
[email protected]

Tennessee
Barbara Loudermilk
Division of Water Resources
Compliance & Enforcement Unit
William R. Snodgrass TN Tower
312 Rosa Parks Blvd, 11th Floor
Nashville, TN 37243
Pennsylvania*
(615) 686-9755 or (615) 313-5742
Department of Environmental Protection [email protected]
Bureau of Laboratories
Attn: Laboratory Accreditation Program Texas
P.O. Box 1467
Penny Sterling
Harrisburg, PA 17105-1467
Texas Commission on Environmental
[email protected]
Quality
P.O. Box 13087, MC 165
Puerto Rico
Austin, TX 78711
Lampros E. Bourodimos, PhD, PE
(512) 239-1617
U.S. EPA Region II, LSASD/MAB/MOS
[email protected]
2890 Woodbridge Ave (MS 220)
Edison, NJ 08837
Utah*
(732) 321-6704
Michael Boeglin
[email protected]
U.S. EPA Region VIII
ECAD/WEB/NWES
1595 Wynkoop St (8ENF-WNW)
Denver, CO 80202
(303) 312-6250
[email protected]

Virginia*
DCLS Laboratory Certification Office
600 N. 5th Street
Richmond, VA 23219
(804) 648-4480
[email protected]
Washington
Rebecca Wood
Washington State Dept. of Ecology
Laboratory Accreditation Unit
P.O. Box 488
Manchester, WA 98353
(360) 871-8811
[email protected]
West Virginia*
Linda B. Keller
West Virginia DEP
601 57th Street, S.E.
Charleston, WV 26304
(304) 926-0495
[email protected]
Wisconsin*
Wisconsin DNR
Laboratory Certification Program - SS/7
PO Box 7921
101 S Webster St.
Madison, WI 53707
(608) 264-6006
[email protected]

Wyoming
Steve E. Vien, PhD
Wyoming DEQ
Water Quality Division
208 South College Drive
Cheyenne, WY 82002
(307) 777-7654
[email protected]
*Some or all permittees in these states may not be required to participate in DMR-QA due to a full or partial waiver agreement with EPA.

Your coordinator may change.
Please visit https://www.epa.gov/compliance/state-discharge-monitoring-report-quality-assurance-dmr-qa-coordinators and
https://www.epa.gov/compliance/regional-discharge-monitoring-report-quality-assurance-dmr-qa-coordinators for the latest
list of coordinators.
For additional questions, contact US EPA Headquarters:
Greg Savitske
USEPA/OECA/OC/MAMPD
1200 Pennsylvania Ave NW
Mail Code 2227A
Washington, DC 20460
(202) 564-2601
[email protected]
Page 8

OMB Control No. 2080-0021 Approval expires xx/xx/xxxx

United States Environmental Protection Agency
Office of Enforcement and Compliance Assurance
1200 Pennsylvania Ave NW, Mail Code 2227A
Washington, DC 20460

DMR-QA Study 40
(This data is collected under the authority of Section 308 of the Clean Water Act.)

Paperwork Reduction Act Notice
The public reporting and recordkeeping burden for this collection of information is estimated to average 6.6 hours 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, DC 20460. Include the OMB control
number (2080-0021), ICR number (0234.13), and EPA form number (6400-01) in any correspondence. Do not send the completed form to
this address.

Instructions for the NPDES Permittee Data Report Form
1.

This is a two-page form.

2.

Enter your NPDES permit number at the top of pages 10 and 11.

3.

You must fill in the 2-digit permit extension field at the top of page 10 if there is an extension for your
permit code. If you have one, the extension will appear next to your permit code in the address box on
page 11; for example: "NPDES Permittee AK1234567-01." If there is no extension, leave this field blank.

4.

Identify each of your laboratories on page 11, including their U.S. EPA Lab code which is a unique
identifier number assigned by EPA. (Refer to page 3, item 4 in the Study 40 package) (NOTE: The U.S.
EPA lab code of the laboratory that produced the data must also appear at the top of the Chemistry/
Microbiology and WET analyte checklists on pages 12-13.)

5.

Make copies of pages 10 and 11. Attach a copy of these pages to the Chemistry/Microbiology and WET
analyte checklists. Separate copies of each checklist must be filled out for each laboratory you used.
Also, if a laboratory reports more than one method to you for any single analyte, you must use a
separate checklist for each method reported. These checklists must indicate the graded results for the
analytes tested by the laboratory that are in your permit and required for DMR-QA (Acceptable or Not
Acceptable). For Study 40, it is optional but encouraged to write in the approved test method used for DMRQA Chemistry/Microbiology analytes. If you use a state-certified laboratory to generate your NPDES data
in a state that has been granted a partial exemption from the DMR-QA study by the EPA Region, check
the "Analyte determined by state-certified laboratory" box(es) on the checklists (pages 12 and 13) for all
analytes in your permit analyzed by a certified laboratory.

6.

Sign and date the certification statement on page 10 and the applicable checklists on pages 11 and 12.

7.

Make copies of the NPDES Permittee Data Report form and checklists for your records.

8.

Submit the signed copy of the Permittee Data Packages by e-mail or postal mail to the State DMR-QA
Coordinator no later than August 28, 2020.

EPA 6400-01 Rev. x-xx. Previous editions are obsolete.

Page 9

OMB Control No. 2080-0021 Approval expires xx/xx/xxxx

United States Environmental Protection Agency
Office of Enforcement and Compliance Assurance
1200 Pennsylvania Ave NW, Mail Code 2227A
Washington, DC 20460

DMR-QA Study 40
(This data is collected under the authority of Section 308 of the Clean Water Act.)

NPDES Permittee Data Report Form
Attention: Follow the instructions on the previous page to complete this form and submit data for evaluation.

Due August 28, 2020

NPDES Permit Number

State

Permit Extension

Permittee Name
Current Permittee Mailing Address
City

State

Phone Number

Fax Number

Zip Code

E-mail

Optional: If WP Study was used, list PT Provider name(s):

Optional: WP Study Number(s)

For DMR-QA Study 40, conducted in 2020, the Permittee ensured that their laboratory(ies) performing the required analyses:
Received PT Samples

Submitted Complete and Accurate Data
by July 2, 2020

Received a Graded Report by
July 31, 2020

Yes

Yes

Yes

No

No

No

Certification by Permit Holder or Authorized Representative
(as per 40 CFR Section 122.22)

I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons
who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. Each reported value was produced from a single analytical run using the analytical system that
routinely performs these analyses to produce compliance monitoring data required under our National Pollutant Discharge Elimination System
(NPDES) permit. Neither I nor any of my subordinates compared our results with results from independent analyses conducted by us or any other
laboratory before we reported our results to the U.S.EPA. I am aware that there are significant penalties for submitting false information, including
the possibility of fine and imprisonment for knowing violations.

Name of Certifying Official

Title

Signature

Date

Address, phone number and e-mail of certifying official are required if different from above.

Address
City

EPA 6400-01 Rev. x-xx. Previous editions are obsolete.

Phone Number
State

Zip Code

Page 10

E-mail

OMB Control No. 2080-0021 Approval expires xx/xx/xxxx

United States Environmental Protection Agency
Office of Enforcement and Compliance Assurance
1200 Pennsylvania Ave NW, Mail Code 2227A
Washington, DC 20460

DMR-QA Study 40
(This data is collected under the authority of Section 308 of the Clean Water Act.)

Permittee Name

State

Permit Extension

NPDES Permit No.

Identification of all CHEM, MICRO and WET laboratories who performed analyses for this permit
Name of Laboratory

Address of Laboratory

U.S. EPA Lab
Code

Lab Analysis
Check box(es) that apply

Chem Micro

WET

Lab
Type*

Statecertified
Lab**

* Lab Types: C = Commercial F = Federal G = Local Government I = Industrial O = Other S = State
** See Footnote on page 2 (Frequently Asked Questions) for the current list of states with lab accreditation programs
If you need additional space, please make a copy of this page for additional laboratories.
EPA 6400-01 Rev. x-xx. Previous editions are obsolete.

Page 11

Permittee Name

State

NPDES Permit No.

EPA Lab Code

Chemistry/Microbiology Analyte Checklist
DMR-QA Study 40

Analyte Test

Test Required

Laboratory's Graded Result

Method Number
Used (optional)

Acceptable

Not Acceptable
(Corrective Action Required)

Analyte determined by
state-certified lab*

Microbiology

E. coli, MF or MPN
Fecal Coliform, MF or MPN
Total Coliform, MF or MPN
Trace Metals

Aluminum
Antimony
Arsenic
Barium
Beryllium
Cadmium
Chromium, total
Chromium, hexavalent
Cobalt
Copper
Iron
Lead
Manganese
Mercury
Mercury (Low Level)
Molybdenum
Nickel
Selenium
Silver
Thallium
Vanadium
Zinc
Demands

5-day BOD
5-day Carbonaceous BOD
COD
TOC
Minerals

Alkalinity, total (CaCO3)
Chloride
Fluoride
Hardness, total (CaCO3)
Specific conductance (25°C)
Sulfate
Total Dissolved Solids (180°C)
Nutrients

Ammonia as N
Nitrate as N
Nitrite as N
Orthophosphate as P
Total Kjeldahl-Nitrogen as N
Total Phosphorus as P
Misc. Analytes

Non-Filterable Residue (TSS)
Oil and Grease
pH
Total Cyanide
Total Phenolics (4-AAP)
Total Residual Chlorine
Total Residual Chlorine (Low Level)
Settleable Solids
Turbidity

Name
* See Footnote on page 2.

Signature
Page 12

Date
Complete a separate checklist for EACH lab.

State

Permittee Name

NPDES Permit No.

EPA Lab Code

WET Analyte Checklist
DMR-QA Study 40

Laboratory's Graded Result

Analyte
Number

Organism / Conditions

Endpoint

Test
Required Acceptable

Not Acceptable
(Corrective Action
Required)

Analyte
determined by
state-certified
lab*

Test Code 13 (refer to EPA Method 2000.0)
754

Fathead minnow (Pimephales promelas) - MHSF 25°C

LC50

Test Code 14 (refer to EPA Method 2000.0)
755

Fathead minnow (Pimephales promelas) - 20% DMW

LC50

Test Code 15 (refer to EPA Method 1000.0)
756

Fathead minnow (Pimephales promelas) - MHSF

NOEC SURVIVAL

808

Fathead minnow (Pimephales promelas) - MHSF

IC25** (ON) GROWTH

810

Fathead minnow (Pimephales promelas) - MHSF

NOEC (ON) GROWTH

Test Code 16 (refer to EPA Method 1000.0)
759

Fathead minnow (Pimephales promelas) - 20% DMW

NOEC SURVIVAL

812

Fathead minnow (Pimephales promelas) - 20% DMW

IC25** (ON) GROWTH

814

Fathead minnow (Pimephales promelas) - 20% DMW

NOEC (ON) GROWTH

Test Code 19 (refer to EPA Method 2002.0)
764

Ceriodaphnia dubia - MHSF 25°C

LC50

Test Code 20 (refer to EPA Method 2002.0)
765

Ceriodaphnia dubia - 20% DMW 25°C

LC50

Test Code 21 (refer to EPA Method 1002.0)
766

Ceriodaphnia dubia - MHSF

NOEC SURVIVAL

767

Ceriodaphnia dubia - MHSF

IC25** REPRODUCTION

768

Ceriodaphnia dubia - MHSF

NOEC REPRODUCTION

Test Code 22 (refer to EPA Method 1002.0)
769

Ceriodaphnia dubia - 20% DMW

NOEC SURVIVAL

770

Ceriodaphnia dubia - 20% DMW

IC25** REPRODUCTION

771

Ceriodaphnia dubia - 20% DMW

NOEC REPRODUCTION

Test Code 32 (refer to EPA Method 2021.0)
788

Daphnia magna - MHSF 25°C

LC50

Test Code 38 (refer to EPA Method 2021.0)
794

Daphnia pulex - MHSF 25°C

LC50

Test Code 42 (refer to EPA Method 2007.0)
798

Mysid (Americamysis bahia, Mysidopsis bahia) 25°C

LC50

Test Code 43 (refer to EPA Method 1007.0)
799

Mysid (Americamysis bahia, Mysidopsis bahia)

NOEC SURVIVAL

816

Mysid (Americamysis bahia, Mysidopsis bahia)

IC25** (ON) GROWTH

818

Mysid (Americamysis bahia, Mysidopsis bahia)

NOEC (ON) GROWTH

Test Code 44 (refer to EPA Method 2006.0)
803

Inland silverside (Menidia berylina) 25°C

LC50

Test Code 45 (refer to EPA Method 1006.0)
824

Inland silverside (Menidia berylina)

NOEC SURVIVAL

825

Inland silverside (Menidia berylina)

IC25** (ON) GROWTH

826

Inland silverside (Menidia berylina)

NOEC (ON) GROWTH

Test Code 46 (refer to EPA Method 2004.0)
804

Sheepshead minnow (Cyprinodon variegatus) 25°C

LC50

Test Code 47 (refer to EPA Method 1004.0)
805

Sheepshead minnow (Cyprinodon variegatus)

NOEC SURVIVAL

820

Sheepshead minnow (Cyprinodon variegatus)

IC25** (ON) GROWTH

822

Sheepshead minnow (Cyprinodon variegatus)

NOEC (ON) GROWTH

Name

Signature

Date

*See Footnote on page 2.
**Preferred endpoint for DMR-QA performance test reporting.

Page 13

Complete a separate checklist for EACH lab.