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Virginia is experiencing pressure to use more marginal lots for development that have site restrictions such as depth to water table and lot size. Advances in wastewater treatment technologies have made the use of these lots feasible. New performance based regulations set standards for the quality and quantity of wastewater applied, but the sampling frequency is too low to ensure that out of compliance treatment units are detected before damage is done. Virginia’s current approval process for treatment units is out-dated, costly, staff intensive and is often criticized for not selecting reliable treatment units. Because the potential for environmental health harm is higher in these marginal sites if a treatment system fails, the need for an approval process that accurately identifies reliable treatment units is critical. This project plan outlines a strategy to develop a new approval process through collaboration with all stakeholders. Stakeholders include homeowners, designers, local governments, and environmental groups. The components and purpose of the approval process must be clearly identified and agreed to so that all affected parties understand what ‘approval’ of a unit means. Stakeholders will be surveyed as to what components are important to them such as reliability, durability, and flexibility. Additionally, neighboring states will be surveyed to determine if there is a potential for reciprocity. Based on the outcome of the surveys, the next step is to develop a process that incorporates the desired components with stakeholder input. A common issue with approval processes is how to evaluate the data statistically. There are multiple methods to address the problem, but all affected parties must agree that the selected methodology is predictive of the performance of the unit. The development of an approval process that incorporates the components that are important to stakeholders and is predictive of actual field performance will provide multiple levels of protection. The process should accurately predict that a unit properly maintained and operated will produce a desired effluent quality. This will result in higher protection of the environment and public health. Note: These documents have not been revised or edited to conform to agency standards. The findings and conclusions in these reports are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.