Table #: Sub-lethal effect of {test material} on {test organism} on day x
| Treatment (mg/l) nominal (measured) concentration | % deformed larvae | Behavioral effects (specify) | Behavioral effects (specify) | Toxicity symptoms (specify) | Toxicity symptoms (specify) | |
| Control (dilution water only) | Replicate #1 |
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| Replicate #2 |
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| |
| Solvent control | Replicate #1 |
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| Replicate #2 |
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| |
| Test concentration 1 | Replicate #1 |
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| Replicate #2 |
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| |
| Test concentration 2 | Replicate #1 |
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|
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| Replicate #2 |
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| |
| Test concentration 3 | Replicate #1 |
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| Replicate #2 |
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| |
| Test concentration n | Replicate #1 |
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| Replicate #2 |
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| |