Form 6400-01 NPDES Permittee Data Report Form

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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 NOTICE TO NPDES PERMITTEES

DMR-QA Study 43 Announcement

IMPORTANT DATES TO REMEMBER
May 19, 2023	DMR-QA Study 43 begins.
June 2, 2023	Submit address verification to State DMR-QA Coordinator.
August 4, 2023	DMR-QA Study 43 ends.
September 29, 2023	Submit DMR-QA 43 Results to State DMR-QA Coordinator.
November 9, 2023	Submit corrective action reports and retest results to State DMR-QA Coordinator, if applicable.

DMR-QA STUDY 43

Immediately verify receipt of DMR-QA Study 43 by either filling out the form below and mailing this page to your State DMR-QA Coordinator (listed on pages 10-11) or follow the e-mail instructions at the bottom of this page.

The mailed form must be postmarked on or before June 2, 2023.

NPDES PERMITTEE ADDRESS VERIFICATION FORM

Discharge Monitoring Report - Quality Assurance (DMR-QA) Study 43

Please provide corrections to the mailing address where all DMR-QA study paperwork should be sent.

NPDES Permit Number

(2-character State Code + 7-digit Permit Code as shown on the mailing label—for example, CT1234567)

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	Zip Code
Phone Number	Fax Number
E-mail Address

ELECTRONIC NOTIFICATION PROCEDURE

You may verify receipt electronically by sending an e-mail on or before June 2, 2023 to your State DMR-QA Coordinator (listed on pages 10-11 of the enclosed instructions). The e-mail should be composed in the following manner:

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 CT1234567).

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; and 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, D.C. 20460

OFFICE OF
ENFORCEMENT AND
COMPLIANCE ASSURANCE

May 15, 2023

Dear NPDES Permit Holder:

This letter initiates the 2023 Discharge Monitoring Report - Quality Assurance (DMR-QA) Study 43. By receipt of this letter, you are required under Clean Water Act (CWA) Section 308 to participate in DMR-QA Study 43 unless your facility is covered by an EPA waiver.^* 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) Program and assures your ability to maintain compliance with NPDES permit requirements and conditions.

DMR-QA Study 43 covers major and select minor NPDES permit holders. You (the permittee) are responsible for ensuring that results of DMR-QA Study 43 tests, performed by your in-house and/or contract laboratories, are graded by an accredited Proficiency Testing (PT) Provider. If any graded test 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.

Recent Changes or Clarifications

• Arkansas DMR-QA participants that report their results to Arkansas’ DMR-QA Coordinator can now submit their DMR-QA Permittee Data Report package through Arkansas DEQ’s e-portal, https://eportal.adeq.state.ar.us/.

• Some language previously contained within the certification statement are now presented as Yes/No questions that must be answered by the person signing the Permittee Data Report Form. EPA will not accept submitted forms that do not answer all five questions immediately above the certification statement on Page 13.

Further Information

Permittees with valid e-mail addresses will receive the DMR-QA Study 43 package 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 9-11. Please reference your NPDES permit number on all correspondence.

Thank you for your attention to this CWA Section 308 requirement.

Sincerely,

/s/

Elizabeth Vizard, Acting Director

Monitoring, Assistance, and Media Programs Division

Office of Compliance

Enclosures

DMR-QA STUDY 43

Table of Contents

DMR-QA Study 43 Frequently Asked Questions 5

NPDES Permittee Instructions 6

Chemistry/Microbiology Laboratory Instructions 7

WET Testing Laboratory Instructions 8

Accredited Proficiency Testing Providers 9

EPA Regional and State DMR-QA Coordinators 9

NPDES Permittee Data Report Form 12

Chemistry/Microbiology Analyte Checklist 15

Whole Effluent Toxicity (WET) Analyte Checklist 16

Schedule and Checklist for DMR-QA Study 43

Deadline*	Permittee	In-House and Contract Laboratories	PT Providers
May 19, 2023	Study 43 begins Notify all laboratories of DMR-QA Study 43	Study 43 begins Order test samples from PT Provider. If using WP study to satisfy DMR-QA requirements, specify that to PT Provider when ordering test samples.
June 2, 2023	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 43 Announcement
August 4, 2023	Study 43 ends	Study 43 ends Send ungraded Data Report to PT Providers (include a list of all NPDES permits using your laboratory data)	Study 43 ends
September 1, 2023			PT Provider to send graded test results, for each permit (listed by NPDES permit numbers), to: ▪ Laboratory ▪ State DMR-QA coordinators
September 15, 2023	After receipt of PT Provider-graded test results, ensure laboratories perform retests for any analytes graded “Not Acceptable”	Forward PT Provider-graded test results to the Permittee Order retest samples from PT Provider for all “Not Acceptable” analyte test results. If retesting using a WP study or quick turnaround PT sample to satisfy a corrective action, data must be reported to the PT Provider by the PT Provider’s published closing date or by October 27, 2023, whichever is earlier.
September 29, 2023	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	Send corrective action letter including any retest results as soon as possible to your Permittee, if applicable
November 9, 2023	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.

DMR-QA Study 43 – 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 10-11). 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.^{†, ‡, §}

What is the purpose of this DMR-QA Study?

The purpose of DMR-QA Study 43 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 43. 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 43. Refer to “WET Testing Laboratory Instructions” (page 8) 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 or the ANSI National Accreditation Board. A list of accredited PT Providers is provided on page 9.

What should permittees and laboratories do first?

Permittees must first confirm receipt of this package by June 2, 2023 to their State DMR-QA Coordinator (pages 10-11) 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 6) for more information. Upon receipt of instructions, laboratories must order samples from an accredited PT Provider (page 9). This should be done early to allow sufficient time to perform the required analyses and send ungraded test results to the PT Provider prior to the close of DMR-QA Study 43 (August 4, 2023). See Laboratory Instructions (pages 7-8) 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 the DMR-QA requirements. However, only test results from WP studies closing between January 1, 2023, and August 4, 2023, will be accepted. See Permittee Instructions for more information (Step 5 on page 6).

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 test 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 15-16, 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 12-13) and submit a signed copy with the completed checklists and copies of the laboratory’s graded reports to the State DMR-QA Coordinator by September 29, 2023.

What do I do if a laboratory receives a “Not Acceptable” test result?

If any graded test results are “Not Acceptable”, the permittee must follow up with the laboratory to determine the cause of that test 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 November 9, 2023. Note: If the laboratory requires a retest to satisfy the corrective action, the laboratory must use a WP study or a quick turnaround PT sample. Data must be reported to the PT Provider by the PT Provider’s published closing date or by October 27, 2023, whichever is earlier.

Can I submit my Permittee Data Report Form electronically?

States may accept scanned, signed copies of the DMR-QA Permittee Data Report package by way of e-mail. Some states such as Arkansas now offer electronic reporting of their DMR-QA Permittee Data Report package. States listed on pages 10 and 11 that are marked with a dagger-style footnote (†) offer their own electronic form of the Study 43 Data Report package.

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-report-quality-assurance-study-program.

NPDES Permittee Instructions

1. Verify that your participation in DMR-QA Study 43 is required by confirming the NPDES permit number on the front of this package or in the e-mail announcement sent to you. If you believe you received this study in error or have questions about your exemption status, contact your State DMR-QA Coordinator (pages 10-11). Please refer to Footnotes 2, 3, and 4 of the Frequently Asked Questions page (page 5) for a list of exempted states.

2. Follow the instructions on the DMR-QA Study 43 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 June 2, 2023. 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 15-16).

4. Ensure that each laboratory uses their U.S. EPA Laboratory Code on all reported test 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 9. Submit all requests for lab codes at least one week before the DMR-QA Study 43 end date (August 4, 2023) 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 43. Your in-house and contract laboratories must order PT samples from an accredited PT Provider (page 9). Ensure your laboratory orders the samples early enough to allow time to perform the required analyses and send test results to the PT Provider prior to the close of DMR-QA Study 43 (August 4, 2023). Your laboratory should register your permit number with the PT Provider prior to August 4, 2023. 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 August 4, 2023. WP studies are only valid for DMR-QA Study 43 if the WP study meets the following requirements:

   1. Samples are offered by an accredited PT Provider (page 9).

   2. The WP study closed between January 1, 2023, and August 4, 2023.

   3. The PT Provider shows the WP test 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 the permittee’s behalf to the PT Provider by the end of DMR-QA Study 43 (August 4, 2023). Laboratories must send ungraded data to the same PT Provider that provided the samples to the laboratory. By September 1, 2023, 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 the PT Provider-graded test results to them by September 15, 2023. Using these graded test results, permittees must fill out the Chemistry/Microbiology Analyte and WET Analyte checklists (pages 15-16) for each laboratory, indicating the analyte tests performed by the laboratory and whether the test 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 test method to you for any single analyte, you must use a separate checklist for each test method reported.

8. Follow the directions on the “NPDES Permittee Data Report Form” (Form 6400-01, pages 12-14) and complete the information. You may use a “fill and print” form available at: https://www.epa.gov/compliance/discharge-monitoring-report-quality-assurance-study-program. By September 29, 2023, you must send a copy of the signed Form 6400-01, graded test results, and completed checklists from step 7 for each of your permits to the State DMR-QA Coordinator.

   1. However, if you (the Permittee) have verified that the PT Provider’s graded test results have been transmitted to the State DMR-QA Coordinator, you are only required to submit the signed 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’ NPDES permit numbers associated with each required analyte to the PT Provider prior to the close of DMR-QA Study 43 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.

   2. 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 the PT Provider-graded test results, permittees must consult with the laboratory and investigate all test results graded by the PT Provider as “Not Acceptable”. Permittees must identify and report to the State DMR-QA Coordinator the causes of any discrepancies and must describe the analytical system changes required to correct the discrepancies. If the laboratory requires a retest to satisfy the corrective action, the laboratory must use a WP study or a quick turnaround PT sample. Data must be reported to the PT Provider by the PT Provider’s published closing date or by October 27, 2023, whichever is earlier. Laboratories must order retesting samples by September 15, 2023, 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 on or before November 9, 2023.

Chemistry/Microbiology Laboratory Instructions

Your laboratory is designated to participate in DMR-QA Study 43 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 2023. 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 2023 will determine which analyses you must perform by checking the appropriate boxes on the enclosed “Chemistry/Microbiology Analyte Checklist” (page 15).

2. Order DMR-QA Study 43 chemistry and microbiology samples from one of the Proficiency Test (PT) Providers (page 9). Be sure to allow yourself enough time to perform the analyses before the closing date of DMR-QA Study 43 (August 4, 2023). Maintain a copy of all completed order forms for your records.

Note: You may be able to utilize the test results from a Water Pollution (WP) study to meet the requirements of DMR-QA Study 43, if all the following conditions are met:

1. Samples are offered by an accredited PT Provider (page 9).

2. The WP study closes between January 1, 2023, and August 4, 2023.

3. The PT Provider shows the WP study results of each permittee’s regulated analytes on the DMR-QA reporting form.

3. Each reported value must be produced from a single analytical run using the analytical system that routinely performs these analyses to produce compliance monitoring data required under your permittee’s NPDES permit. Your results must not be compared with results from other independent analyses conducted by you or any other laboratory before reporting your test results to the PT Provider.

4. Record your ungraded analytical data and your EPA Lab Code on the Data Reporting Forms that you received with your test samples. Be sure to follow the PT Provider’s instructions and deadlines that you received with these samples.

5. You are required to use the EPA-assigned Lab Code on all reported test results. 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 9).

6. 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 sent you the test samples. Make sure you provide the DMR-QA Study 43 or WP study results to the PT Provider by August 4, 2023. If you choose to use a WP study, you must report all data to the PT Provider by the PT Provider’s published WP study close date, even if it is prior to the DMR-QA deadline of August 4, 2023. Notify the PT Provider that the WP study is being used to satisfy DMR-QA Study 43 requirements and send them copies of the analyte checklist(s) if you are reporting via hard copy.

7. The PT Provider will grade your analyses and send the graded test results to you by September 1, 2023. If the PT Provider is submitting graded test 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 43 or the WP study. Forward the graded test results of the analytes to the permittee by September 15, 2023, so the permittee can fill out the analyte checklist on page 15.

8. If any graded test results are “Not Acceptable”, laboratories should coordinate with the permittee to determine the cause of that test result and identify corrective action to prevent future occurrences. If the laboratory requires a retest to satisfy the corrective action, the laboratory must use a WP study or a quick-turnaround PT sample. Data must be reported to the PT Provider by the PT Provider’s published closing date or by October 27, 2023, whichever is earlier. Laboratories must order retest samples for “Not Acceptable” analyte test results by September 15, 2023. The corrective action report and graded retest results must be forwarded to the permittee as soon as possible, for the permittee is required to submit a completed corrective action report to their state DMR-QA coordinator by November 9, 2023.

WET Testing Laboratory Instructions

Your laboratory is designated to participate in DMR-QA Study 43 by a NPDES permittee because the permittee uses or plans to use your laboratory to perform Whole Effluent Toxicity (WET) analyses during 2023. 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 short-term chronic marine West Coast WET test methods (1995).

1. The permittee(s) determine which analyses you will perform by checking the appropriate boxes on the enclosed WET Analyte checklist (page 16). Labs should ensure that the permittee has selected the test organism(s), test conditions, and testing requirements 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 16 to select the proper WET tests.

   Guidelines for Choosing the Correct WET Test Organism/Conditions/Test Endpoint(s):

   • Laboratories should only report one test endpoint for each DMR-QA WET test code required.

   • For laboratory performance quality assurance purposes only, the point estimation techniques that produce test endpoints such as the Inhibiting Concentration 25% (IC25) are the preferred statistical approach used for calculating test endpoints for effluent chronic toxicity tests. However, laboratories should choose the statistical approach that allows calculation of the test 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) test endpoint for Survival and it is reported regularly on DMRs, this test endpoint may be reported for DMR-QA.

   • If the permit requires WET testing with the Fathead minnow (Pimephales promelas), Ceriodaphnia dubia, Daphnia magna, Daphnia pulex, Americamysis bahia (Mysidopsis bahia), Inland silverside (Menidia beryllina) or Sheepshead minnow (Cyprinodon variegatus), the laboratory must test with those test 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, then conduct this test using the static non-renewal 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, then 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 test organisms included in Study 43, use the 48-hr acute test conditions specified in the WET Test Codes.

   • If the permit requires 20°C acute testing for any test organisms included in Study 43, use 25°C acute test conditions specified in the WET Test Codes.

2. Order DMR-QA toxicity samples from an accredited PT Provider (page 9). Allow yourself enough time to perform the analyses before the closing date of DMR-QA Study 43 (August 4, 2023). Maintain a copy of all completed order forms for your records.

3. Each reported value must be produced from a single analytical run using the analytical system that routinely performs these analyses to produce compliance monitoring data required under your permittee’s NPDES permit. Your results must not be compared with results from other independent analyses conducted by you or any other laboratory before reporting your test results to the PT Provider.

4. Record your ungraded analytical data and EPA Lab Code on the Data Report Form received with your samples. Be sure to follow the PT Provider’s instructions and deadlines that you received with the samples. You must use the EPA-assigned Lab Code on all reported test results. If you need a new EPA Lab Code or need to verify your current code, contact your EPA Regional DMR-QA Coordinator (page 9).

5. 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 sent you the test samples. Make sure you provide the DMR-QA Study 43 study results by August 4, 2023.

6. The PT Provider will grade your test results and send them to you by September 1, 2023. If the PT Provider is submitting graded test 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 43 or the WP study. Forward the graded test results of the analytes to the permittee by September 15, 2023, so the permittee can fill out the analyte checklist on page 16.

7. If any graded test 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. If the laboratory requires a retest to satisfy the corrective action, the laboratory must use a WP study or a quick turnaround PT sample. Data must be reported to the PT Provider by their published closing date or by October 27, 2023, whichever is earlier. Laboratories must order retest samples for “Not Acceptable” analyte test results by September 15, 2023. The corrective action report and graded retest results must be forwarded to the permittee as soon as possible, for the permittee is required to submit a completed corrective action report to their state DMR-QA coordinator by November 9, 2023.

Reference Manuals: (see https://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. https://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=46584.

Accredited Proficiency Testing Providers

The following Proficiency Test (PT) Providers are accredited by the American Association for Laboratory Accreditation (A2LA) or the ANSI National Accreditation Board (ANAB). A2LA and ANAB have each been designated a Proficiency Testing Oversight Body/Proficiency Testing Provider Accreditor 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	✔	✔
Advanced Analytical Solutions, LLC, Parkersburg, WV Fred Anderson (304) 485-6325 [email protected] www.advancedqa.com	✔	✔
Environmental Resource Associates (ERA), Golden, CO (800) 372-0122 [email protected]; [email protected] www.eraqc.com	✔	✔	✔
MilliporeSigma, Laramie, WY (800) 576-5690 [email protected] www.sigmaaldrich.com/pt	✔	✔	✔
New York State Department of Health Wadsworth Center, Albany, NY Amy C. DeMarco (518) 473-1398 [email protected] www.wadsworth.org/programs/ehs/pt	✔	✔
NSI Lab Solutions, Raleigh, NC Quentisha Forrester (800) 234-7837 [email protected] www.nsilabsolutions.com	✔	✔
Phenova Inc., Golden, CO (866) 942-2978 [email protected] www.phenova.com	✔	✔	✔

EPA Regional DMR-QA Coordinators

EPA Region 1

(CT, MA, ME, NH, RI, VT)

Bhavita Patel

U.S. EPA Region 1

LSASD/LQAB

11 Technology Drive

North Chelmsford, MA 01863-2431

(617) 918-8322

[email protected]

EPA Region 2 (NJ, NY, PR, VI)

Molly Hillenbrand

U.S. EPA Region II

LSASD/MAB/MOS

2890 Woodbridge Ave (MS 220)

Edison, NJ 08837

(732) 321-4452

[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 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 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 6 (AR, LA, NM, OK, TX)

Magda Vargas

U.S. EPA Region VI

ECAD/WTREB/WRS

1201 Elm St, Suite 500 (6ECDWR)

Dallas, TX 75270

(214) 665-7396

[email protected]

EPA Region 7 (IA, KS, MO, NE)

Peggy Mnich

U.S. EPA Region VII

ECAD/WB

11201 Renner Blvd

Lenexa, KS 66219

(913) 551-7075

[email protected]

EPA Region 8 (CO, MT, ND, SD, UT, WY)

Lisa-kay Prideaux

U.S. EPA Region VIII

ECAD/WEB/NWES

10 West 15th Street (8MO)

Helena, MT 59626

(406) 457-5022

[email protected]

Trying to find your
State DMR-QA Coordinator? Turn to pages 10 and 11 ➜

EPA Region 9

(AS, AZ, CA, GU, HI, MP, MW, NN, NV)

Adam Howell

U.S. EPA Region IX

ECAD/WB/WS1

75 Hawthorne St (ENF-3-1)

San Francisco, CA 94105

(415) 972-4248

[email protected]

EPA Region 10 (AK, ID, OR, WA)

Stacey Kim

U.S. EPA Region X

ECAD/WEFB/SWES

1200 Sixth Ave

Seattle, WA 98101

(206) 553-1380

[email protected]

State DMR-QA Coordinators

Alabama

Autumn Baughn

Alabama Dept. of Environmental Mgmt.

OEQ-QSU

1350 Coliseum Boulevard

Montgomery, AL 36110

(334) 271-4162

[email protected]

Alaska

John Clark

Alaska DEC - Division of Water

555 Cordova St

Anchorage, AK 99501-2617

(907) 269-3066

[email protected]

American Samoa

Adam Howell

U.S. EPA Region IX

ECAD/WB/WS1

75 Hawthorne St (ENF-3-1)

San Francisco, CA 94105

(415) 972-4248

[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^**††

Yvette Wilkins

Arkansas Department of Energy
and Environment

5301 Northshore Drive

North Little Rock, AR 72118

(501) 682-0941

[email protected]

https://eportal.adeq.state.ar.us/

California*

Andrew Hamilton

Office of Information Mgmt & Analysis State Water Resources Control Board

1001 I Street, 16-39D

Sacramento, CA 95814

(916) 341-5286

[email protected]

Colorado

Jocelyn Brink

Colorado Dept. of Public Health and Environment

Water Quality Control Division-CWE-B2

4300 S Cherry Creek Drive South

Denver, CO 80246

(720) 507-4518

[email protected]

Connecticut

Susan Unger

Connecticut DEEP

Bureau of Materials Management and Compliance Assurance

79 Elm Street

Hartford, CT 06106

(860) 424-3286

[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]

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]

Florida

William Joyner

U.S. EPA Region IV, ECAD/WEB/WES

61 Forsyth St SW, MC-9T25

Atlanta, GA 30303-8960

(404) 562-8795

[email protected]

Georgia

Sam Wright

Georgia DNR

Environmental Protection Division

Watershed Protection Branch

2 MLK Jr. Dr., S.W., Suite 1152 East

Atlanta, GA 30334

(470) 524-1643

[email protected]

Guam

Maricar Quezon

Water Pollution Control Program

Guam EPA

P.O. Box 22439

Barrigada, GU 96921

(671) 475-1601

[email protected]

Hawaii

Randee Tubal

Hawaii Department of Health

Clean Water Branch

2827 Waimano Home Road, Room 225

Pearl City, HI 96782

(808) 586-4309

[email protected]

Idaho

Stacey Kim

U.S. EPA Region X

ECAD/WEFB/SWES

1200 Sixth Ave

Seattle, WA 98101

(206) 553-1380

[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]

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]

Iowa

Peggy Mnich

U.S. EPA Region VII, ECAD/WB

11201 Renner Blvd

Lenexa, KS 66219

(913) 551-7075

[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]

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]

Louisiana*

Sandy Coon

Louisiana DEQ

Office of Environmental Compliance

P.O. Box 4312

Baton Rouge, LA 70821-4312

(225) 219-3614

[email protected]

Maine*

Brett Goodrich

Maine Dept. of Environmental Protection

Division of Water Quality Management

17 State House Station

Augusta, ME 04333

(207) 287-9034

[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]

Massachusetts

Ping Yee

Massachusetts DEP/Boston Office

100 Cambridge St, Suite 800

Boston, MA 02114

(617) 634-9744

[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

Beverly Ashmore-Bates

Mississippi DEQ

Office of Pollution Control

1542 Old Whitfield Road

Pearl, MS 39208

(601) 961-5737

[email protected]

Missouri

Peggy Mnich

U.S. EPA Region VII, ECAD/WB

11201 Renner Blvd

Lenexa, KS 66219

(913) 551-7075

[email protected]

Montana

Gina Self

Montana DEQ

Water Protection Bureau

P.O. Box 200901

Helena, MT 59620-0901

(406) 444-5388

[email protected]

Nebraska

Reuel Anderson

Nebraska Department of Environment and Energy

Water Quality Division

P.O. Box 98922

Lincoln, NE 68509

(402) 471-1367

[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]

(List continues 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*

Department of Environmental Protection

Office of Quality Assurance

Laboratory Certification Programs

P.O. Box 402, Mail Code 401-02D

Trenton, NJ 08625-0402

(609) 777-1749

New Mexico

Jason Martinez

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) 372-8376

[email protected]

New York

Molly Hillenbrand

U.S. EPA Region II, LSASD/MAB/MOS

2890 Woodbridge Ave (MS 220)

Edison, NJ 08837

(732) 321-4452

[email protected]

North Carolina*

Todd Crawford

North Carolina DEQ

Division of Water Resources

Laboratory Certification Branch

1623 Mail Service Center

Raleigh, NC 27699-1623

(919) 733-3908, ext. 251

[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

Adam Howell

U.S. EPA Region IX

ECAD/WB/WS1

75 Hawthorne St (ENF-3-1)

San Francisco, CA 94105

(415) 972-4248

[email protected]

Ohio

Steve Roberts

Ohio EPA

8955 East Main Street

Reynoldsburg, OH 43068

(614) 644-4225

[email protected]

Oklahoma*

Lynzie Chan

Oklahoma DEQ

P.O. Box 1677

Oklahoma City, OK 73101

(405) 702-8243

[email protected]

Oregon

George Cannon

Oregon DEQ

Water Quality Permitting and Program Development

700 NE Multnomah St, Ste 600

Portland, OR 97232

(503) 734-9843

[email protected]

Pennsylvania*

Department of Environmental Protection

Bureau of Laboratories

Attn: Laboratory Accreditation Program

P.O. Box 1467

Harrisburg, PA 17105-1467

[email protected]

Puerto Rico

Molly Hillenbrand

U.S. EPA Region II, LSASD/MAB/MOS

2890 Woodbridge Ave (MS 220)

Edison, NJ 08837

(732) 321-4452

[email protected]

Rhode Island

Matthew Puglia, PE

Rhode Island DEM

Office of Water Resources

235 Promenade Street

Providence, RI 02908

(401) 222-4700, ext. 7131

[email protected]

South Carolina*

Bennie L. Cockerel

Office of Environmental Lab Certification

SC DHEC Bureau of
Environmental Services

2600 Bull St

Columbia, SC 29201

(803) 896-0974

[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

(615) 686-9755 or (615) 313-5742

[email protected]

Texas

Penny Sterling

Texas Commission on Environmental Quality

P.O. Box 13087, MC 165

Austin, TX 78711

(512) 239-1617

[email protected]

Utah*

Lisa-kay Prideaux

U.S. EPA Region VIII

ECAD/WEB/NWES

10 West 15th Street (8MO)

Helena, MT 59626

(406) 457-5022

[email protected]

Vermont

Amy Polaczyk

Vermont DEC

1 National Life Dr. - Bldg Main 2

Montpelier, VT 05620-3522

(802) 490-6185

[email protected]

Virgin Islands

Molly Hillenbrand

U.S. EPA Region II, LSASD/MAB/MOS

2890 Woodbridge Ave (MS 220)

Edison, NJ 08837

(732) 321-4452

[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*

Justin Carpenter

West Virginia DEP

601 57th Street, S.E.

Charleston, WV 25304

(304) 926-0499, ext. 43765

[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]

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]

	United States Environmental Protection Agency Office of Enforcement and Compliance Assurance DMR-QA Study 43 (This data is collected under the authority of Section 308 of the Clean Water Act.)																OMB Control No. 2080-0021 Approval expires xx/xx/xxxx
																	2 023
Instructions for the NPDES Permittee Data Report Form: This is a two-page form. All fields on page 13 are required to be reported except for those explicitly marked as optional. Enter your NPDES permit number at the top of pages 13 and 14. You must fill in the 2-digit permit extension field at the top of page 13 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 13; for example: “NPDES Permittee CT1234567-01”. If there is no extension, leave this field blank. Identify each of your laboratories on page 14, including their U.S. EPA Lab Code which is a unique identifier number assigned by EPA. (Refer to page 6, item 4 in the Study 43 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 15-16.) Make copies of pages 13 and 14. 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 test method to you for any single analyte, you must use a separate checklist for each test method reported. These checklists must indicate the graded test results for the analytes tested by the laboratory that are in your permit and required for DMR-QA (Acceptable or Not Acceptable). For Study 43, it is optional but encouraged to write in the approved EPA test method used for DMR- QA 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 15 and 16) for all analytes in your permit analyzed by a state-certified laboratory. Sign and date the certification statement on page 13 and the applicable checklists on pages 15 and 16. Forms that do not have a signed certification statement by the permit holder or authorized representative will be considered invalid. Make copies of the NPDES Permittee Data Report form and checklists for your records. Submit the signed copy of the Permittee Data Packages by e-mail or postal mail to the State DMR-QA Coordinator no later than September 29, 2023.
Paperwork Reduction Act Burden Statement. This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2080-0021). Responses to this collection of information are mandatory for Major and select Minor NPDES permit holders under Clean Water Act section 308 [33 U.S.C. § 1318]. 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 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 to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave NW, Washington, DC 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.
NPDES Permittee Data Report Form Attention: Follow the instructions on the previous page to complete this form and submit data for evaluation.
Due September 29, 2023							NPDES Permit Number (State + 7-digit ID)											Permit Extension
Permittee Name
Current Permittee Mailing Address
City										State					Zip Code
Phone Number				Fax Number						E-mail Address
Optional: If WP Study was used, list PT Provider name(s):
Optional: IF WP Study was used, list WP Study Number(s):
For DMR-QA Study 43, conducted in 2023, the Permittee ensured that their laboratory(ies) performing the required analyses:
Received PT Samples					Submitted Complete and Accurate Data by August 4, 2023								Received a Graded Report by September 1, 2023
YES ❏   NO ❏					YES ❏   NO ❏								YES ❏   NO ❏
Each reported value was produced from a single analytical run using the analytical system that routinely performs these analyses to produce compliance monitoring data under our 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 U.S. EPA.
YES ❏   NO ❏								YES ❏   NO ❏
Certification by Permit Holder or Authorized Representative 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. 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											Phone Number
City			State			Zip Code					E-mail Address
Permittee Name									NPDES Permit Number (State + 7-digit ID)											Permit Extension
Identification of all CHEM, MICRO and WET laboratories who performed analyses for this permit
Laboratory Name		Laboratory Address							U.S. EPA Lab Code			Lab Analysis Check box(es) that apply							Lab Type*		State-certified Lab**
												Chem		Micro		WET
												❏		❏		❏					❏
												❏		❏		❏					❏
												❏		❏		❏					❏
												❏		❏		❏					❏
												❏		❏		❏					❏
												❏		❏		❏					❏
* Lab Types: C = Commercial; F = Federal; G = Local Government; I = Industrial; O = Other; S = State ** See Footnotes 2, 3, and 4 on page 5 (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.

Permittee Name

NPDES Permit No.

EPA Lab Code

Chemistry/Microbiology Analyte Checklist DMR-QA Study 43

2023

Analyte Test	Test Required	Method Number Used (Optional)	Laboratory’s Graded Result		Analyte determined by state-certified lab*
			Acceptable	Not Acceptable (Corrective Action Required)
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

Signature

Date

* See Footnotes 2 through 4 on page 5 Complete a separate checklist for EACH lab.

Permittee Name

NPDES Permit No.

EPA Lab Code

Whole Effluent Toxicity (WET) Analyte Checklist DMR-QA Study 43

2023

Analyte Number	Organism / Conditions	Endpoint	Test Required	Laboratory’s Graded Result		Analyte determined by state-certified lab*
				Acceptable	Not Acceptable (Corrective Action Required)
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 beryllina) 25°C	LC50	❏	❏	❏	❏
Test Code 45 (refer to EPA Method 1006.0)		———————	———	———	——————	—————
824	Inland silverside (Menidia beryllina)	NOEC SURVIVAL	❏	❏	❏	❏
825	Inland silverside (Menidia beryllina)	IC25** (ON) GROWTH	❏	❏	❏	❏
826	Inland silverside (Menidia beryllina)	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 Footnotes 2 through 4 on page 5 ** Preferred endpoint for DMR-QA performance test reporting				Complete a separate checklist for EACH lab.

* EPA is authorized to collect this information under Section 308 of the CWA, 33 U.S.C. § 1318. This information request is enforceable under Section 309 of the CWA, 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 5 to determine if you are covered by an EPA waiver or contact your State DMR-QA Coordinator.

† As of April 1, 2023, permittees in the following states have laboratory quality assurance programs approved by EPA as a substitute for DMR-QA Study 43: California, Kansas, Kentucky, New Jersey, Nevada, North Carolina, Pennsylvania, South Carolina, Utah, Virginia, West Virginia, and Wisconsin.

‡ Louisiana has an approved laboratory quality assurance program for commercial laboratories only.

§ NPDES permittees in Arkansas, Maine, New Hampshire, and Oklahoma that have all their wastewater laboratories covered by their state laboratory accreditation program are also exempted from DMR-QA Study 43; any permittee that has a laboratory not fully certified by the state must perform the DMR-QA study.
Check with your State DMR-QA Coordinator if you have questions about your state’s waiver status.

** Some or all permittees in these states may not be required to participate in DMR-QA Study 43 due to a full or partial waiver agreement with EPA.

†† Some or all permittees in Arkansas can now submit their DMR-QA Study 43 results electronically through Arkansas DEQ’s ePortal website (see website link, above).

‡‡ Some or all permittees in these states may not be required to participate in DMR-QA Study 43 due to a full or partial waiver agreement with EPA.