Information Collection

Construction Sand and Gravel and Crushed and Broken Stone, Form 9-4142-Q

IC 179291 under ICR 200702-1028-003 · OMB 1028-0065.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1028-0065 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 9-4142-Q Construction Sand and Gravel and Crushed and Broken Stone, Form 9-4142-Q	Form
9-4142-Q Crushed and Broken Stone & Construction Sand and Gravel 1028-0065 form 9-4142-Q.pdf	Form

IC Title:

Construction Sand and Gravel and Crushed and Broken Stone, Form 9-4142-Q

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	9-4142-Q	Crushed and Broken Stone & Construction Sand and Gravel	1028-0065 form 9-4142-Q.pdf		Yes	Yes	Fillable Fileable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,068

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 30 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1,068	1,068
Annual IC Time Burden (Hours)	178	178
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.