"APPLICATION FOR PREAUTHORIZATION OF A CERCLA RESPONSE ACTION" AND "CLAIM FOR CERCLA RESPONSE ACTION"

ICR 199409-2050-001

OMB: 2050-0106

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
2050-0106 199409-2050-001
Historical Active 199111-2050-002
EPA/OLEM
"APPLICATION FOR PREAUTHORIZATION OF A CERCLA RESPONSE ACTION" AND "CLAIM FOR CERCLA RESPONSE ACTION"
No material or nonsubstantive change to a currently approved collection   No
Emergency 09/26/1994
Approved with change 09/26/1994
Retrieve Notice of Action (NOA) 09/26/1994
  Inventory as of this Action Requested Previously Approved
03/31/1995 03/31/1995 12/31/1994
103 0 103
13,314 0 13,314
0 0 0

IN ORDER TO BE REIMBURSED FROM THE HAZARDOUS SUBSTANCE SUPERFUND FOR THE COST OF CONDUCTING A RESPONSE ACTION IN ACCORDANCE WITH THE NATIONAL CONTINGENCY PLAN, AN INDIVIDUAL, PRIVATE ENTITY, FOREIGN ENTITY, OR POTENTIALLY RESPONSIBLE PARTY (INCLUDING STATES AND POLITIC SUBDIVISIONS) MUST FIRST COMPLETE AND SUBMIT TO EPA AN APPLICATION FOR PREAUTHORIZATION AND A CLAIM FORM. EPA WILL USE THE INFORMATION

None
None


No

1
IC Title Form No. Form Name
"APPLICATION FOR PREAUTHORIZATION OF A CERCLA RESPONSE ACTION" AND "CLAIM FOR CERCLA RESPONSE ACTION" 1304.03

  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 103 103 0 0 0 0
Annual Time Burden (Hours) 13,314 13,314 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
09/26/1994


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