The Clean Water Act establishes a nationwide approach to improve and maintain the quality of rivers, streams, lakes, and other water bodies, which involves different programs aimed at reducing pollution of the nation's waters. Under this approach, states are to set water quality standards, monitor water quality, and assess water quality against the applicable standards. Through the monitoring and assessment process, states are to identify water bodies that do not meet their standards, and these water bodies are considered to be impaired. Under the act, point source dischargers of pollutants must obtain permits, issued by authorized states or EPA regions.