Information Collection

Water Efficiency Collection - Private Sector

IC 46015 under ICR 201001-2040-002 · OMB 2040-0272.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2040-0272 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 6100-09 Water Efficiency Collection - Private Sector	Form and Instruction
6100-06 Partnership Agreement Promotional Partner Attachment 1 promo PA.pdf www.epa.gov/watersense/docs/partnership_promopartners508.pdf	Form and Instruction
6100-12 Partnership Agreement Retailer Distributer Attachment 2 partnership_retail-distributrs508.pdf www.epa.gov/watersense/docs/partnership_retail-distributrs508.pdf	Form and Instruction
6100-13 Partnership Agreement Manufacturer Attachment 3 partnership_manufacturers508.pdf www.epa.gov/watersense/docs/partnership_manufacturers508.pdf	Form and Instruction
6100-XX1 Partnership Agreement Builder Attachment 4 partnership_builder.pdf	Form and Instruction
6100-20 Partnership Agreement Certification Provider Attachment 5 partnership_provider_508rw.pdf	Form and Instruction
6100-18 New Certified Product Urinal Attachment 9 Urinal Product Notification Form_final.pdf	Form and Instruction
6100-11 New Certified Product Toilet Attachment 7 het_notification_form.pdf www.epa.gov/watersense/docs/het_notification_form508.pdf	Form and Instruction
6100-15 New Certified Product Faucet Attachment 8 faucet_notification_form.pdf www.epa.gov/watersense/docs/faucet_notification_form508.pdf	Form and Instruction
6100-09 Annual Reporting Form Promotional Partner Attachment 10 Promo partner annual data_2009_fillable.pdf epa.gov/watersense/docs/annualdata_promo508.pdf	Form and Instruction
6100-09 Annual Reporting Form Manufacturer Attachment 11 Manufacturer 2010-13-09_Fillable.pdf epa.gov/watersense/docs/annualdata_manufacturer508.pdf	Form and Instruction
6100-09 Annual Reporiting Form Retailer Attachment 12 annualdata_retail508.pdf epa.gov/watersense/docs/annualdata_retail508.pdf	Form and Instruction
6100-XX2 Annual Reporting Form Builder Attachment 13 builder annual data_draft.pdf	Form and Instruction
6100-XX3 Annual Reporting Form Professional Certifying Organizati Attachment 14 Certifying Org_PartnerReporting.pdf	Form and Instruction
6100-XX5 Annual Reporting Form Licensed Certifying Body Attachment 16 LCB Annual Report Form_12-28-07.pdf	Form and Instruction
6100-17 Awards Application Promotional Partner Attachment 17 awards_promo.pdf epa.gov/watersense/docs/awards_promo508.pdf	Form and Instruction
6100-17 Awards Application Manufacturer Attachment 18 awards_manufacturer.pdf epa.gov/watersense/docs/awards_manufacturer508.pdf	Form and Instruction
6100-17 Awards Application Retailer Attachment 19 awards_retail dist.pdf epa.gov/watersense/docs/awards_retail508.pdf	Form and Instruction
6100-XX6 Draft Provider Quarterly Reporting Form Attachment 21 draft quarterly reporting form.pdf	Form and Instruction
6100-XX7 Retailer Location Form Attachment 23 Retailer Location Form.xls	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Water Efficiency Collection - Private Sector

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	6100-09	Annual Reporting Form Manufacturer	Attachment 11 Manufacturer 2010-13-09_Fillable.pdf	http://epa.gov/watersense/docs/annualdata_manufacturer508.pdf	Yes	No	Fillable Printable
Form and Instruction	6100-09	Annual Reporiting Form Retailer	Attachment 12 annualdata_retail508.pdf	http://epa.gov/watersense/docs/annualdata_retail508.pdf	Yes	No	Fillable Printable
Form and Instruction	6100-XX2	Annual Reporting Form Builder	Attachment 13 builder annual data_draft.pdf		Yes	Yes	Printable Only
Form and Instruction	6100-XX3	Annual Reporting Form Professional Certifying Organization	Attachment 14 Certifying Org_PartnerReporting.pdf		Yes	Yes	Printable Only
Form and Instruction	6100-XX5	Annual Reporting Form Licensed Certifying Body	Attachment 16 LCB Annual Report Form_12-28-07.pdf		Yes	Yes	Printable Only
Form and Instruction	6100-17	Awards Application Promotional Partner	Attachment 17 awards_promo.pdf	http://epa.gov/watersense/docs/awards_promo508.pdf	Yes	Yes	Fillable Printable
Form and Instruction	6100-17	Awards Application Manufacturer	Attachment 18 awards_manufacturer.pdf	http://epa.gov/watersense/docs/awards_manufacturer508.pdf	Yes	Yes	Fillable Printable
Form and Instruction	6100-17	Awards Application Retailer	Attachment 19 awards_retail dist.pdf	http://epa.gov/watersense/docs/awards_retail508.pdf	Yes	Yes	Fillable Printable
Form and Instruction	6100-06	Partnership Agreement Promotional Partner	Attachment 1 promo PA.pdf	http://www.epa.gov/watersense/docs/partnership_promopartners508.pdf	Yes	Yes	Fillable Printable
Form and Instruction	6100-12	Partnership Agreement Retailer Distributer	Attachment 2 partnership_retail-distributrs508.pdf	http://www.epa.gov/watersense/docs/partnership_retail-distributrs508.pdf	Yes	Yes	Fillable Printable
Form and Instruction	6100-13	Partnership Agreement Manufacturer	Attachment 3 partnership_manufacturers508.pdf	http://www.epa.gov/watersense/docs/partnership_manufacturers508.pdf	Yes	Yes	Fillable Printable
Form and Instruction	6100-XX1	Partnership Agreement Builder	Attachment 4 partnership_builder.pdf		Yes	Yes	Printable Only
Form and Instruction	6100-20	Partnership Agreement Certification Provider	Attachment 5 partnership_provider_508rw.pdf		Yes	Yes	Printable Only
Form and Instruction	6100-18	New Certified Product Urinal	Attachment 9 Urinal Product Notification Form_final.pdf		Yes	Yes	Printable Only
Form and Instruction	6100-11	New Certified Product Toilet	Attachment 7 het_notification_form.pdf	http://www.epa.gov/watersense/docs/het_notification_form508.pdf	Yes	Yes	Fillable Printable
Form and Instruction	6100-15	New Certified Product Faucet	Attachment 8 faucet_notification_form.pdf	http://www.epa.gov/watersense/docs/faucet_notification_form508.pdf	Yes	Yes	Fillable Printable
Form and Instruction	6100-09	Annual Reporting Form Promotional Partner	Attachment 10 Promo partner annual data_2009_fillable.pdf	http://epa.gov/watersense/docs/annualdata_promo508.pdf	Yes	Yes	Fillable Printable
Form and Instruction	6100-XX6	Draft Provider Quarterly Reporting Form	Attachment 21 draft quarterly reporting form.pdf		Yes	Yes	Printable Only
Form and Instruction	6100-XX7	Retailer Location Form	Attachment 23 Retailer Location Form.xls		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Environmental Management

Subfunction: Environmental Remediation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,319

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,319	892	427
Annual IC Time Burden (Hours)	14,024	7,303	6,721
Annual IC Cost Burden (Dollars)	1,782,900	1,659,614	123,286

Documents for IC

table that charts IC Documents
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.