Information Collection

Tremolite Asbestos Registry - Baseline Surveys

IC 43624 under ICR 200909-0923-001 · OMB 0923-0039.

Documents and Forms

Document Name Document Type
Form No number Tremolite Asbestos Registry - Baseline Surveys Form
No number TAR Adult and Child Baseline Surveys Appendix D (Baseline Surveys).doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Tremolite Asbestos Registry - Baseline Surveys	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	No number	TAR Adult and Child Baseline Surveys	Appendix D (Baseline Surveys).doc		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-19-0001 Records of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances	FR Citation: 59 FR 67085

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	500	-1,000	1,500
Annual IC Time Burden (Hours)	250	-430	680
Annual IC Cost Burden (Dollars)	0	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.