REQUESTS FOR HEALTH ASSESSMENTS -- 42 CFR PART 90

ICR 199402-0923-001

OMB: 0923-0002

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
111119
Migrated
ICR Details
0923-0002 199402-0923-001
Historical Active 199012-0923-001
HHS/TSDR
REQUESTS FOR HEALTH ASSESSMENTS -- 42 CFR PART 90
Revision of a currently approved collection   No
Regular
Approved without change 05/18/1994
Retrieve Notice of Action (NOA) 02/15/1994
  Inventory as of this Action Requested Previously Approved
06/30/1997 06/30/1997 02/28/1994
60 0 30
30 0 15
0 0 0

THIS INFORMATION COLLECTION PROVIDES A MECHANISM FOR THE PUBLIC TO REQUEST THAT A HEALTH ASSESSMENT(S) BE CONDUCTED BY ATSDR AT A SITE OR LOCATION WHERE THEY MAY HAVE A CONCERN THAT EXPOSURE TO HAZARDOUS SUBSTANCES MAY BE AN ISSUE.

None
None


No

1
IC Title Form No. Form Name
REQUESTS FOR HEALTH ASSESSMENTS -- 42 CFR PART 90

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 60 30 0 30 0 0
Annual Time Burden (Hours) 30 15 0 15 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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.
02/15/1994


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