Information Collection

State Primacy Agencies

IC 45664 under ICR 201002-2040-001 · OMB 2040-0275.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 999 State Primacy Agencies	Form
999 Contaminant Occurrence Data in Support of EPA's Third Si Six-Year - 3 ICR Instrument Placeholder 12 14 09.doc	Form

IC Title:

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	999	Contaminant Occurrence Data in Support of EPA's Third Six-Year Review of National Primary Drinking Water Regulations; EPA ICR No. 2231.02, OMB Control No. 2040-01	Six-Year - 3 ICR Instrument Placeholder 12 14 09.doc		No	No	Paper Only

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	19	0	19
Annual IC Time Burden (Hours)	756	75	681
Annual IC Cost Burden (Dollars)	0	0	0

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.