Baseline Safety and Health Practices Survey - State, Local and Tribal

Baseline Safety and Health Practices Survey

Documents and Forms

Document Name Document Type
BASELINE SAFETY AND HEALTH PRACTICES State and Local Governments (10-28-10).pdf Other-Telephone Survey

Information Collection (IC) Details

IC Title:	Baseline Safety and Health Practices Survey - State, Local and Tribal	Agency IC Tracking Number:	1218-0NEW(2010)

Is this a Common Form? No		IC Status: New

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
Other-Telephone Survey			BASELINE SAFETY AND HEALTH PRACTICES State and Local Governments (10-28-10).pdf		No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	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.