Information Collection

Private Sector

IC 192208 under ICR 201003-2040-001 · OMB 2040-0281.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Questionnaire Instructions_051810.pdf	Instruction
Part A_051310.pdf	Other-Survey - Part A
Part B_051310.pdf	Other-Survey - Part B
Part C_051310.pdf	Other-Survey - Part C
Part D_051310.pdf	Other-Survey - Part D
Part E_051310.pdf	Other-Survey - Part E
Part F_051310.pdf	Other-Survey - Part F
Part G_051310.pdf	Other-Survey - Part G
Part H_051310.pdf	Other-Survey - Part H
Part I_051810.pdf	Other-Survey - Part I
Part A_022210.xls	Other-Excel Version Survey - Part A
Part B _022210.xls	Other-Excel Version Survey - Part B
Part C_022210.xls	Other-Excel Version Survey - Part C
Part D_022210.xls	Other-Excel Version Survey - Part D
Part E_022210.xls	Other-Excel Version Survey - Part E
Part F_022210.xls	Other-Excel Version Survey - Part F
Part G_022210.xls	Other-Excel Version Survey - Part G
Part H_022210.xls	Other-Excel Version Survey - Part H
Part I_022210.xls	Other-Excel Version Survey - Part I

IC Title:

Private Sector

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Excel Version Survey - Part I	Part I_022210.xls	Yes	Yes	Fillable Fileable
Other-Excel Version Survey - Part A	Part A_022210.xls	Yes	Yes	Fillable Fileable
Other-Excel Version Survey - Part B	Part B _022210.xls	Yes	Yes	Fillable Fileable
Other-Excel Version Survey - Part C	Part C_022210.xls	Yes	Yes	Fillable Fileable
Other-Excel Version Survey - Part D	Part D_022210.xls	Yes	Yes	Fillable Fileable
Other-Excel Version Survey - Part E	Part E_022210.xls	Yes	Yes	Fillable Fileable
Other-Excel Version Survey - Part F	Part F_022210.xls	Yes	Yes	Fillable Fileable
Other-Excel Version Survey - Part G	Part G_022210.xls	Yes	Yes	Fillable Fileable
Other-Excel Version Survey - Part H	Part H_022210.xls	Yes	Yes	Fillable Fileable
Instruction	Questionnaire Instructions_051810.pdf	Yes	No	Printable Only
Other-Survey - Part A	Part A_051310.pdf	Yes	No	Printable Only
Other-Survey - Part C	Part C_051310.pdf	Yes	No	Printable Only
Other-Survey - Part D	Part D_051310.pdf	Yes	No	Printable Only
Other-Survey - Part E	Part E_051310.pdf	Yes	No	Printable Only
Other-Survey - Part G	Part G_051310.pdf	Yes	No	Printable Only
Other-Survey - Part F	Part F_051310.pdf	Yes	No	Printable Only
Other-Survey - Part H	Part H_051310.pdf	Yes	No	Printable Only
Other-Survey - Part I	Part I_051810.pdf	Yes	No	Printable Only
Other-Survey - Part B	Part B_051310.pdf	Yes	No	Printable Only

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 734

Number of Respondents for Small Entity: 250

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	245	245
Annual IC Time Burden (Hours)	41,049	41,049
Annual IC Cost Burden (Dollars)	405,683	405,683

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.