In 1994, the National Small Flows Clearinghouse undertook the project of learning about the status of onsite systems across the country by contacting those in the local and state public health agencies who work with these systems every day. Approximately 3500 agencies were sent a questionnaire containing questions about onsite systems. The project objectives included determining the following for each state for the year 1993: which local agencies work with onsite systems the number of new onsite systems permitted reasons for permit denial permit costs types of onsite technologies permitted/allowed number of onsite systems reported to have failed reasons for system failure new onsite system construction/installation cost how often onsite system inspections are performed who has responsibility for onsite system maintenance The most common reasons given for permit denial were inadequate lot size, high water table, poor/inadequate soils, shallow bedrock, and central sewer availability. Health departments attributed failure of onsite systems to the following factors: age, unsuitable soils, lack of maintenance/pumping, high groundwater table, and excessive water use. Many health departments noted a correlation between failing systems and either inadequate or nonexistent regulations. Inspections are generally performed by health department personnel or a designated representative. Maintenance is the responsibility of the homeowner. One recurring observation made by the local health departments was that sites which previously would never have been considered for onsite system use are now being purchased, planned, and developed with onsite wastewater treatment in mind. These findings will provide information about alternative and conventional onsite systems across the country that will be helpful not only to local and state agencies, but also to regulators, researchers, educators, installers, and private citizens in demonstrating situations that occur across the country that are faced by others.