Part 2 of 2: State and Local Governments

Schools Chemical Cleanout Campaign (SC3)

Documents and Forms

Document Name Document Type
Form 6200-06 Part 2 of 2: State and Local Governments Form and Instruction
Preservice_-_SCRIPT_for_ICR_2.doc Other-Script for Focus Group Discuss
6200-06 Annual Update Annual_Update_06_29_09 Protected.doc Form and Instruction
6200-05 Initial Survey Initial_Survey_06_29_09 Protected.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Part 2 of 2: State and Local Governments	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	6200-06	Annual Update	Annual_Update_06_29_09 Protected.doc	Yes	Yes	Fillable Fileable
Form and Instruction	6200-05	Initial Survey	Initial_Survey_06_29_09 Protected.doc	Yes	Yes	Fillable Fileable
Other-Script for Focus Group Discussion			Preservice_-_SCRIPT_for_ICR_2.doc	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: 7	Number of Respondents for Small Entity: 1

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 70 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7	7
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	2	2

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.