Low Back Exposure Assessment Tool for Mining

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Low Back Exposure Assessment Tool for Mining	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	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

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.