Information Collection

State Agencies

IC 180159 under ICR 201010-2080-001 · OMB 2080-0021.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2080-0021 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form EPA 6400-01 (OMB 2 State Agencies	Form and Instruction
EPA 6400-01 (OMB 2 NPDES Permittee Data Report Form rptform-print.pdf	Form and Instruction
EPA 6400-01 (OMB 2 NPDES Permittee Data Report Form rptform.pdf	Form and Instruction

IC Title:

State Agencies

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	EPA 6400-01 (OMB 2080-0021)	NPDES Permittee Data Report Form	rptform-print.pdf		No	No	Printable Only
Form and Instruction	EPA 6400-01 (OMB 2080-0021)	NPDES Permittee Data Report Form	rptform.pdf		Yes	No	Fillable Printable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,148

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,148	-443	0	3,591
Annual IC Time Burden (Hours)	19,833	-2,790	0	22,623
Annual IC Cost Burden (Dollars)	598,120	-73,095	78,700	592,515

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.