THIS FORM IS DESIGNED TO COLLECT DATA
FOR SEVERAL TYPES OF WATER SUPPLIES, USING A VARIETY OF INFORMATION
SOURCES. IT WILL BE USED TO CONSTRUCT A CURRENT AND HISTORICAL
PICTURE OF WATER QUALITY, ESPECIALLY WITH REGARD TO CHLORINATED AND
OTHER ORGANIC CHEMICALS. THE FORM SHOULD BE FILLED OUT FOR EACH
WATER SUPPLY IN YOUR AREA WHICH HAS EVER SERVED MORE THAN 1000
PERSONS.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.