Information Collection

Low Back Exposure Assessment Tool for Mining

IC 181183 under ICR 200707-0920-002 · OMB 0920-0758.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Low Back Exposure Assessment Tool for Mining	Form and Instruction
Appendix D.Low Back assessment.doc	Other-Recruiting Announcement for Vo
Appendix C: Low Back Assessment Appendix C.Low Back Assessment.doc	Form and Instruction

IC Title:

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 and Instruction	None	Appendix C: Low Back Assessment	Appendix C.Low Back Assessment.doc		No	No	Fillable Fileable
Other-Recruiting Announcement for Volunteers			Appendix D.Low Back assessment.doc		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 320

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	320	320
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	8,320	8,320

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.