Information Collection

Anticipated Residue DCIs: Updated Public Source Monitoring Data

IC 186762 under ICR 200809-2070-002 · OMB 2070-0174.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2070-0174 can be found here:

Documents and Forms

Document Name Document Type
Form 8570-4 Anticipated Residue DCIs: Updated Public Source Monitoring Data Form and Instruction
8570-4 CSF 8570-4_pjsrevised.pdf www.epa.gov/opprd001/forms/ Form and Instruction
8570-27 Formulator's Exemption 8570-27_pjsrevised.pdf www.epa.gov/opprd001/forms/ Form and Instruction
8570-28 Cert. of Compliance 8570-28-cgs.pdf www.epa.gov/opprd001/forms/ Form and Instruction
8570-32 Cert. Attempt Agreement 8570-32_pjsrevised.pdf www.epa.gov/opprd001/forms/ Form and Instruction
8570-34 Cert Respect Data 8570-34_pjsrevised.pdf www.epa.gov/opprd001/forms/ Form and Instruction
8570-35 Dtat Matrix 8570-35_pjsrevised.pdf www.epa.gov/opprd001/forms/ Form and Instruction
8570-36 Summary Physical 8570-36_pjsrevised.pdf www.epa.gov/opprd001/forms/ Form and Instruction
8570-37 Self Cert. Physical 8570-37_pjsrevised.pdf www.epa.gov/opprd001/forms/ Form and Instruction
6300.4 DCI Response 6300.4 DCI response.pdf Form and Instruction
6300.3 Requirements and Status 6300.3 DCI_requirements-response.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Anticipated Residue DCIs: Updated Public Source Monitoring Data	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

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	8570-4	CSF	8570-4_pjsrevised.pdf	http://www.epa.gov/opprd001/forms/	Yes	No	Fillable Printable
Form and Instruction	8570-27	Formulator's Exemption	8570-27_pjsrevised.pdf	http://www.epa.gov/opprd001/forms/	Yes	No	Fillable Printable
Form and Instruction	8570-28	Cert. of Compliance	8570-28-cgs.pdf	http://www.epa.gov/opprd001/forms/	Yes	No	Fillable Printable
Form and Instruction	8570-32	Cert. Attempt Agreement	8570-32_pjsrevised.pdf	http://www.epa.gov/opprd001/forms/	Yes	No	Fillable Printable
Form and Instruction	8570-34	Cert Respect Data	8570-34_pjsrevised.pdf	http://www.epa.gov/opprd001/forms/	Yes	No	Fillable Printable
Form and Instruction	8570-35	Dtat Matrix	8570-35_pjsrevised.pdf	http://www.epa.gov/opprd001/forms/	Yes	No	Fillable Printable
Form and Instruction	8570-36	Summary Physical	8570-36_pjsrevised.pdf	http://www.epa.gov/opprd001/forms/	Yes	No	Fillable Printable
Form and Instruction	8570-37	Self Cert. Physical	8570-37_pjsrevised.pdf	http://www.epa.gov/opprd001/forms/	Yes	No	Fillable Printable
Form and Instruction	6300.4	DCI Response	6300.4 DCI response.pdf		No	No	Paper Only
Form and Instruction	6300.3	Requirements and Status	6300.3 DCI_requirements-response.pdf		No	No	Paper Only

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,643	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	4	4
Annual IC Time Burden (Hours)	548	548
Annual IC Cost Burden (Dollars)	0	0

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.