In accordance with the guidelines of the State Program Review Framework, EPA Region 9 conducted reviews of Hawaii Department of Healths Air Stationary Source, Water NPDES, and RCRA Subtitle C programs during 2006, examining performance during Federal Fiscal Year 2005. All three program review teams commend Hawaii DOH for preparing complete and thorough inspection reports, and maintaining well organized files for completed inspections and enforcement cases. Hawaii Department of Health places a strong priority on returning facilities to compliance. Where violations were found, all three programs determined that HI DOH took effective action, whether formal or informal, to return facilities to compliance (including assessment of penalties as appropriate). Hawaii DOH met most of its inspection commitments during the review period. HIDOH exceeded inspection targets for its air program (majors and synthetic minors); met its commitment for RCRA TSD inspections; exceeded its commitment for RCRA LQG inspections; and exceeded national averages in inspection of major permittees under NPDES. Hawaii Department of Health can improve its enforcement program by providing enhanced attention to timely, accurate and complete data reporting. We anticipate that fuller staffing in FY 2007 and recent assignment of an Attorney General will enable greater emphasis on formal enforcement actions and case conclusions. Specific recommendations for each program are included in the detailed reports.