Summary of IC

0572-0121 spreadsheet revision Oct 09.xls

7 CFR 1780, Water and Waste Loan and Grant Program

Summary of IC

OMB: 0572-0121

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USDA - RUS
Title of Information Document




OMB No.



Water and Waste Loan and Grant Program





0572-0121
SUMMARY OF INFORMATION COLLECTION
7 CFR 1780




Date Prepared









Oct-09
INSTRUCTIONS:

> (f) TOTAL
(h) TOTAL
(k) TOTAL
Use this form when a single information collection document involves multiple reporting and


> - = (e) Average - = (g) Average - = (j) Average
recordkeeping requirements.


> (d) TOTAL
(f) TOTAL
(i) TOTAL
IDENTIFICATION OF REPORTING AND RECORDKEEPPING REQUIREMENTS




ANNUAL BURDEN





FORM

REPORTS


RECORDS


NO(s) NO. OF NO. OF TOTAL HOURS TOTAL NO. OF ANNUAL TOTAL
SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS RECORD- HOURS PER RECORD-
REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g) KEEPERS RECORD- KEEPING




RESPON- (Col. d & e)


KEEPER HOURS




DENT




(Col. i & j)
(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)

NON-FORM BURDEN








1780.1(f) Relationship or association with RUS employees Written 835 1 835 0.25 209

7 CFR 1777-Colonias (0572-0109)
65 1 65 0.25 16



7 CFR 1778-ECWAG (0572-0110)
100 1 100 0.25 25










1780.7(d) Statement on availability to obtain credit elsewhere Written 835 1 835 1.00 835

7 CFR 1777-Colonias
65 1 65 1.00 65



7 CFR 1778-ECWAG
100 1 100 1.00 100













1780.11(a)(2) Notification of service statement Written 250 1 250 2.00 500



7 CFR 1777-Colonias
20 1 20 2.00 40

7 CFR 1778-ECWAG
30 1 30 2.00 60













1780.14(a)(3) & (b)(2) Liens on real and chattel property Written 167 1 167 1.00 167



7 CFR 1777-Colonias
13 1 13 1.00 13



7 CFR 1778-ECWAG
20 1 20 1.00 20













1780.14(b)(2) Financing Statement Written 250 1 250 1.00 250



7 CFR 1777-Colonias
20 1 20 1.00 20



7 CFR 1778-ECWAG
30 1 30 1.00 30













1780.19 Public Information Written 835 1 835 2.00 1,670



7 CFR 1777-Colonias
65 1 65 2.00 130



7 CFR 1778-ECWAG
100 1 100 2.00 200














SUBTOTAL


3,800 1.14 4,350












TOTAL HOURS THIS COLLECTION


50,933 3.04 154,909 14,000 0.08 1,120
1780.33(b) Intergovernmental comments Written 1,010 1 1,010 1.00 1,010



7 CFR 1777-Colonias
75 1 75 1.00 75



7 CFR 1778-ECWAG
115 1 115 1.00 115













1780.33(c) Preliminary engineering report Written 1,010 1 1,010 4.00 4,040



7 CFR 1777-Colonias
75 1 75 4.00 300



7 CFR 1778-ECWAG
115 1 115 4.00 460













1780.33(e) Supporting documentation Written 1,010 1 1,010 6.00 6,060



7 CFR 1777-Colonias
75 1 75 6.00 450



7 CFR 1778-ECWAG
115 1 115 6.00 690













1780.33(h)(5) Certification Regarding Debarment AD-1047 835 1 835 0.25 209



7 CFR 1777-Colonias
65 1 65 0.25 16



7 CFR 1778-ECWAG
100 1 100 0.25 25













1780.33(h)(6) Certification Regarding Drug-Free Workplace AD-1049 835 1 835 0.25 209



7 CFR 1777-Colonias
65 1 65 0.25 16



7 CFR 1778-ECWAG
100 1 100 0.25 25













1780.39(b)(1) and (2) Agreements for professional services Written 835 1 835 4.00 3,340



7 CFR 1777-Colonias
65 1 65 4.00 260



7 CFR 1778-ECWAG
100 1 100 4.00 400













1780.39(b)(4) Contracts for other services Written 501 1 501 2.00 1,002



7 CFR 1777-Colonias
39 1 39 2.00 78



7 CFR 1778-ECWAG
60 1 60 2.00 120














SUBTOTAL


7,200 2.63 18,900


1780.39(c)(5)(i) Positive programs to encourage connections Written 167 1 167 3.00 501



7 CFR 1777-Colonias
13 1 13 3.00 39



7 CFR 1778-ECWAG
20 1 20 3.00 60













1780.39(c)(3) User agreement Written 89 1 89 4.00 356



7 CFR 1777-Colonias
7 1 7 4.00 28



7 CFR 1778-ECWAG
4 1 4 4.00 16













1780.39(d) Interim financing Written 900 1 900 4.00 3,600



7 CFR 1777-Colonias
0 1 0 4.00 0



7 CFR 1778-ECWAG
0 1 0 4.00 0













1780.39(g)(3) Fidelity or employee dishonesty Bond Written 751 1 751 4.00 3,004



7 CFR 1777-Colonias
59 1 59 4.00 236



7 CFR 1778-ECWAG
90 1 90 4.00 360










1780.39(g)(4) Property insurance Written 751 1 751 1.00 751



7 CFR 1777-Colonias
59 1 59 1.00 59



7 CFR 1778-ECWAG
90 1 90 1.00 90













1780.39(g)(5) General Liability Insurance Written 751 1 751 1.00 751



7 CFR 1777-Colonias
59 1 59 1.00 59



7 CFR 1778-ECWAG
90 1 90 1.00 90













1780.39(g)(6) Flood Insurance Written 89 1 89 1.00 89



7 CFR 1777-Colonias
7 1 7 1.00 7



7 CFR 1778-ECWAG
4 1 4 1.00 4














SUBTOTAL


4,000 2.53 10,100


1780.39(g)7) Workman's compensation insurance Written 751 1 751 0.50 376



7 CFR 1777-Colonias
59 1 59 0.50 30



7 CFR 1778-ECWAG
90 1 90 0.50 45













1780.44(f) Evidence of other funds Written 250 1 250 1.00 250



7 CFR 1777-Colonias
20 1 20 1.00 20



7 CFR 1778-ECWAG
30 1 30 1.00 30













1780.44(g)(3) Water rights Written 100 1 100 3.00 300



7 CFR 1777-Colonias
7 1 7 3.00 21



7 CFR 1778-ECWAG
4 1 4 3.00 12













1780.44(g) Appraisal Report Written 42 1 42 2.00 84



7 CFR 1777-Colonias
3 1 3 1.00 3



7 CFR 1778-ECWAG
5 1 5 1.00 5













1780.44(g)(1)(ii) User Connections Written 25 1 25 3.00 75



7 CFR 1777-Colonias
2 1 2 1.00 2



7 CFR 1778-ECWAG
3 1 3 1.00 3













1780.44(g)(4) Lease agreement Written 42 1 42 5.00 210



7 CFR 1777-Colonias
3 1 3 5.00 15



7 CFR 1778-ECWAG
5 1 5 5.00 25













1780.45(a) Notes, bonds, warrants or other contractural obligations Written 835 1 835 5.00 4,175



7 CFR 1777-Colonias
0 1 0 5.00 0



7 CFR 1778-ECWAG
0 1 0 5.00 0














SUBTOTAL


2,276 2.50 5,680


1780.45(a)(2) Loan Resolution (Public Bodies) RUS Bulletin 1780-27 668 1 668 1.00 668



7 CFR 1777-Colonias
0 1 0 1.00 0



7 CFR 1778-ECWAG
0 1 0 1.00 0













1780.45(a)(2) Loan Resolution, Security Agreement RUS Bulletin 1780-28 167 1 167 1.00 167



7 CFR 1777-Colonias
0 1 0 1.00 0



7 CFR 1778-ECWAG
0 1 0 1.00 0













1780.45(c) Grant Agreement RUS Bulletin 1780-12 535 1 535 1.00 535



7 CFR 1777-Colonias
65 1 65 1.00 65



7 CFR 1778-ECWAG
100 1 100 1.00 100













1780.47(d) Audits Written 5,835 1 5,835 8.00 46,680



7 CFR 1777-Colonias
65 1 65 8.00 520



7 CFR 1778-ECWAG
100 1 100 8.00 800













1780.47(f) Management report Written 835 4 3,340 8.00 26,720



7 CFR 1777-Colonias
65 4 260 8.00 2,080



7 CFR 1778-ECWAG
100 4 400 8.00 3,200













1780.61 Construction contract forms Written 835 1 835 3.00 2,505



7 CFR 1777-Colonias
65 1 65 3.00 195



7 CFR 1778-ECWAG
100 1 100 3.00 300



SUBTOTAL


12,535 6.74 84,535


1780.61(b) Borrower attorney's certification of construction contract Written 835 1 835 15.00 12,525



7 CFR 1777-Colonias
65 1 65 15.00 975



7 CFR 1778-ECWAG
100 1 100 15.00 1,500













1780.63 Sewage treatment and bulk water sales contracts Written 89 1 89 3.00 267



7 CFR 1777-Colonias
7 1 7 3.00 21



7 CFR 1778-ECWAG
4 1 4 3.00 12













1780.74 Contracts awarded prior to application Written 20 1 20 2.00 40



7 CFR 1777-Colonias
1 1 1 2.00 2



7 CFR 1778-ECWAG
1 1 1 2.00 2













1780.76(b) Monitoring construction Written 835 1 835 5.00 4,175



7 CFR 1777-Colonias
65 1 65 5.00 325



7 CFR 1778-ECWAG
100 1 100 5.00 500













1780.76(c) Resident Inspector resume Written 835 1 835 2.00 1,670



7 CFR 1777-Colonias
65 1 65 2.00 130



7 CFR 1778-ECWAG
100 1 100 2.00 200













1780.76(d) Daily inspection report Written 835 18 15,030 0.50 7,515



7 CFR 1777-Colonias
65 18 1,170 0.50 585



7 CFR 1778-ECWAG
100 18 1,800 0.50 900













1780.37(b) Borrower shall maintain accounting records for 3 years




7,000 0.08 560

Contractor required records





7,000 0.08 560












SUBTOTAL


21,122 1.48 31,344



FORMS APPROVED UNDER OTHER OMB NUMBERS








1780.44(g)(2) Preliminary Title Opinion RD 1927-9 835 1 835 1.50 1,253



7 CFR 1777-Colonias (0575-0147) 65 1 65 1.50 98



7 CFR 1778-ECWAG
100 1 100 1.50 150













1780.44(g)(2) Final Title Opinion RD 1927-10 835 1 835 0.34 284



7 CFR 1777-Colonias (0575-0147) 65 1 65 0.34 22



7 CFR 1778-ECWAG
100 1 100 0.34 34













1780.76(e) Partial Payment Estimate RD 1924-18 835 1 835 0.50 418



7 CFR 1777-Colonias (0575-0042) 65 1 65 0.50 33



7 CFR 1778-ECWAG
100 1 100 0.50 50













1780.76(h)(2) Contract Change Order RD 1924-7 835 1 835 0.25 209



7 CFR 1777-Colonias (0575-0042) 65 1 65 0.25 16



7 CFR 1778-ECWAG
100 1 100 0.25 25













1780.33(h)(3) Equal Opportunity Agreement RD 400-1 835 1 835 0.08 67



7 CFR 1777-Colonias (0575-0018) 65 1 65 0.08 5



7 CFR 1778-ECWAG
100 1 100 0.08 8













1780.33(h)(4) Assurance Agreement RD 400-4 835 1 835 0.25 209



7 CFR 1777-Colonias (0575-0018) 65 1 65 0.25 16



7 CFR 1778-ECWAG
100 1 100 0.25 25













1780.33(a) Application for Federal Assistance SF 424 1,010 1 1,010 1.00 1,010



7 CFR 1777-Colonias (4040-0004) 75 1 75 1.00 75



7 CFR 1778-ECWAG
115 1 115 1.00 115













1780.33(h)(1) Operating Budget RD 442-7 835 1 835 5.00 4,175



7 CFR 1777-Colonias (0575-0015) 65 1 65 5.00 325



7 CFR 1778-ECWAG
100 1 100 5.00 500













1780.41(a)(3) Balance Sheet or Financial Statement RD 442-3 835 1 835 1.00 835



7 CFR 1777-Colonias (0575-0015) 65 1 65 1.00 65



7 CFR 1778-ECWAG
100 1 100 1.00 100













1780.29(b)(1) Agreement for Engineering Services 1942-19 835 1 835 4.00 3,340



7 CFR 1777-Colonias (0575-0015) 65 1 65 4.00 260



7 CFR 1778-ECWAG
100 1 100 4.00 400













1780.39(f) Resolution of Members or Stockholders RD 1942-8 167 1 167 1.00 167



7 CFR 1777-Colonias (0575-0015) 13 1 13 1.00 13



7 CFR 1778-ECWAG
20 1 20 1.00 20













1780.41(a)(6) Letter of Intent to Meet Conditions RD 1942-46 835 1 835 1.00 835



7 CFR 1777-Colonias (0575-0015) 65 1 65 1.00 65



7 CFR 1778-ECWAG
100 1 100 1.00 100













1780.44(g)(1)(i) Opinion of Counsel Relative to Right-of-Way and Easements RD 442-22 835 1 835 1.00 835



7 CFR 1777-Colonias (0575-0015) 65 1 65 1.00 65



7 CFR 1778-ECWAG
100 1 100 1.00 100













1780.45(b)(1)(ii) Estimate of Funds Needed for 30-Day Period Commencing ____" RD 440-11 751 1 751 1.00 751



7 CFR 1777-Colonias (0575-0015) 59 1 59 1.00 59



7 CFR 1778-ECWAG
90 1 90 1.00 90













1780.37(f) Statement of Budget, Income, and Equity RD 442-2 835 1 835 2.50 2,088



7 CFR 1777-Colonias (0575-0015) 65 1 65 2.50 163



7 CFR 1778-ECWAG
100 1 100 2.50 250













1780.62 Water Purchase Contract RD 442-30 167 1 167 1.00 167



7 CFR 1777-Colonias (0575-0015) 13 1 13 1.00 13



7 CFR 1778-ECWAG
20 1 20 1.00 20













1780.75 Certification of Contractor's Lease RD 1924-9 835 1 835 0.25 209



7 CFR 1777 - Colonias (0575-0042) 65 1 65 0.25 16



7 CFR 1778 -ECWAG
100 1 100 0.25 25













1780.75 Release by Claimants RD 1924-10 835 1 835 0.50 418



7 CFR 1777 - Colonias (0575-0042) 65 1 65 0.50 33



7 CFR 1778 -ECWAG
100 1 100 0.50 50













1780.76(f) Insepction Report RD 1924-12 835 3 2,505 0.25 626



7 CFR 1777 - Colonias (0575-0042) 65 3 195 0.25 49



7 CFR 1778 -ECWAG
100 3 300 0.25 75













1780.45(a) Promissory Note RD 440-22 835 1 835 0.25 209



7 CFR 1777 - Colonias (0575-0015) 65 1 65 0.25 16



7 CFR 1778 -ECWAG
100 1 100 0.25 25
























RUS Form 36 (07-91)





















































































































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AuthorDawn Wolfgang
Last Modified Bymichele.brooks
File Modified2009-11-05
File Created1999-05-21
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