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Water Efficiency Collection - Private Sector
EPA's WaterSense Program (Renewal)
OMB: 2040-0272
IC ID: 46015
OMB.report
EPA/OW
OMB 2040-0272
ICR 201001-2040-002
IC 46015
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2040-0272 can be found here:
2021-06-30 - Extension without change of a currently approved collection
2019-03-22 - Extension without change of a currently approved collection
Documents and Forms
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:
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 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,319
0
892
0
0
427
Annual IC Time Burden (Hours)
14,024
0
7,303
0
0
6,721
Annual IC Cost Burden (Dollars)
1,782,900
0
1,659,614
0
0
123,286
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.