Information Collection Request

Environmental Health Specialists Network (EHS-NET) Program

ICR 200804-0920-006 · OMB 0920-0792 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Worker screener and consent Form New Available
Worker interview Form New Available
Kitchen observation Form New Available
Manager survey Form New Available
Manager Interview Form New Available
Manager Recruitment Screener Form New Available
Data Collection Instrument Form New Available
Recruiting Screener Form New Available
Supporting Statement Part B- EHS-Net.doc Supporting Statement B Uploaded 2008-03-05 Available
Attachment 3- Example of retail food service workers data collection.doc Supplementary Document Uploaded 2008-04-15 Available
60 day FRN-E7-14389.pdf Supplementary Document Uploaded 2008-03-05 Available
Attachment 2- 60 day FRN.doc Supplementary Document Uploaded 2008-03-05 Available
Supporting Statement Part A- EHS-Net (2).doc Supporting Statement A Uploaded 2008-03-05 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
197287 EHS-Net Kitchen Manager Certification Study Form NewWorker screener and consent
197287 EHS-Net Kitchen Manager Certification Study Form NewWorker interview
197287 EHS-Net Kitchen Manager Certification Study Form NewKitchen observation
197287 EHS-Net Kitchen Manager Certification Study Form NewManager survey
197287 EHS-Net Kitchen Manager Certification Study Form NewManager Interview
197287 EHS-Net Kitchen Manager Certification Study Form NewManager Recruitment Screener
188941 EHS-NET Program Food Service Establishment Cooling Practices Study Form NewData Collection Instrument
188941 EHS-NET Program Food Service Establishment Cooling Practices Study Form NewRecruiting Screener

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2011 36 Months From Approved
10,375 0 0
15,563 0 0
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
EHS-NET Program Food Service Establishment Cooling Practices Study none, none ,  
EHS-Net Kitchen Manager Certification Study none, none, none, none, none, none ,   ,   ,   ,   ,  

table that charts list of burden
  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 10,375 0 10,375 0 0 0
Annual Time Burden (Hours) 15,563 0 15,563 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No