State, Local, Tribal Government Reporting

EPA Form: 6200-18
OMB Control No.: 2050-0192
Expiration Date: XX-XX-XXXX

INSTRUCTIONS FOR COMPLETING CERCLA 128(a) STATE AND TRIBAL
PROGRAM ACTIVITY LEVELS (PALs) FORM
GENERAL INSTRUCTIONS
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control
No. 2050-0192). Responses to this collection of information are mandatory (2 CFR 200.328, 2 CFR 200.333, 2 CFR 200.335, 40
CFR 30-31). 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 public reporting and recordkeeping burden for this collection of
information is estimated to be 2 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 to the Regulatory Support Division
Director, U.S. Environmental Protection Agency (2821T), 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.

Overview:
As specified in your cooperative agreement terms and conditions, all CERCLA 128(a) State and
Tribal cooperative agreement recipients must report to EPA on a regular basis. This OMB and
EPA approved reporting form (OMB No. 2050-0192, EPA Form 6200-18) supplements your
Quarterly or Semiannual Reports with information about specific activities and accomplishments
that EPA deems necessary to adequately monitor and evaluate progress toward goals defined in
the cooperative agreements. Please contact your EPA Regional representative if you have any
questions when completing this form.
Compared to the Quarterly or Semiannual Reports, the PALs Form contains quantitative
information on eight specific measures of recipient performance. Reporting on these specific
activities and accomplishments must be provided in the attached PALs Form rather than in the
Quarterly or Semiannual Reports.
When to Submit:
Cooperative agreement recipients must submit a PALs form annually when the annual funding
submission is due to EPA. Generally, this occurs mid-December.
To Whom to Submit:
Cooperative agreement recipients must submit PALs Reporting Forms to their EPA Regional
Representative identified in the terms and conditions or the cooperative agreement. Beginning in
FY 2023, CARs must submit PALs information directly into EPA’s Assessment, Cleanup, and
Redevelopment Exchange System (ACRES). Data entered online will be automatically
delivered to the EPA Regional Representative.
How to Submit:
ACRES is available online and is the preferred method for the CERCLA 128(a) State and Tribal
cooperative agreement recipients to enter and submit the PALs Reporting Form. Until FY 2023,
electronic reporting in ACRES is optional, and the PALs Reporting Form may instead be
submitted in hard copy via e-mail to the EPA Regional Representative. In FY 2023 and beyond,
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EPA Form: 6200-18
OMB Control No.: 2050-0192
Expiration Date: XX-XX-XXXX

CARs must submit PALs information directly into ACRES. Please contact your EPA Regional
representative if you have any questions on submitting the PALs form.
DETAILED INSTRUCTIONS FOR COMPLETING EACH ITEM ON FORM
PART I – COOPERATIVE AGREEMENT RECIPIENT INFORMATION
1. State or Tribe. Enter the state or tribe that received the CERCLA 128(a) cooperative
agreement
2. Cooperative Agreement Recipient Name. Enter the cooperative agreement recipient
name. Use the official name provided in the cooperative agreement, unless otherwise
directed by the EPA Regional Representative.
3. Cooperative Agreement Number. Enter the cooperative agreement number. Use the
number as provided in the cooperative agreement.
PART II – PROGRAM ACTIVITY INFORMATION
4. Select one or more of the following environmental programs where CERCLA
Section 128(a) funds were used to support capacity-building (general program
support, non-site-specific work) in the last federal fiscal year. Indicate, as appropriate,
which environmental programs are supported by CERCLA 128(a) funds. The list of
programs are Brownfields, Underground Storage Tanks/Leaking Underground Storage
Tanks, Federal Facilities, Solid Waste, Superfund, Hazardous Waste Facilities, VCP
(Voluntary Cleanup Program, Independent Cleanup Program, etc.), and/or Other.
5. Number of properties (or sites) enrolled in a response program during the last
federal fiscal year. Enter the number of properties enrolled in the response program.
Include both traditional enrollment programs and programs that track properties under
other oversight activities.
6. Number of properties (or sites) where documentation indicates that cleanup work is
complete AND all required Institutional Controls (“ICs”) or Engineering Controls
(“ECs”) are either in place or not required (during the last federal fiscal year). Enter
the number of properties where documentation demonstrated that all cleanup work is
completed, and all required ICs / ECs are in place or not required.
6a. Total number of acres associated with properties (or sites) identified in number 6
above. Enter the corresponding total acreage of all properties/sites counted in 6 above.
7. If ICs / ECs have previously been placed on properties (or sites), the total number of
audits, inspections, reviews, or other types of monitoring that have been conducted
in the last federal fiscal year to ensure that the ICs / ECs are still maintained and
fully effective. Enter the number of audits, inspections, reviews, or other types of
monitoring conducted to ensure properties with engineering and institutional controls are
still in place and protective of human health and the environment.
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EPA Form: 6200-18
OMB Control No.: 2050-0192
Expiration Date: XX-XX-XXXX

8. Date of the last update to the Public Record. Enter the date of the last Public Record
update for the response program.
9. OPTIONAL - Total number of properties where assistance was provided, but the
properties were not enrolled in a response program. Enter the total number of
properties where assistance was provided but the property was not enrolled in a response
program.
10. Did you develop or revise legislation, regulations, codes, guidance documents or
policies related to establishing or enhancing your Voluntary Cleanup
Program/Response Program during the most recent fiscal year? Enter whether your
program has developed or revised legislation, regulations, codes, guidance documents or
policies related to your program in the most recent year.
10a. If yes, please indicate the type and whether it was new or revised. If yes, enter text
to indicate the type of legislation, regulations, codes, guidance documents or policies and
indicate ‘new’ or ‘revised.’

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