Facility Certification Document

Coal Workers' Health Surveillance Program (CWHSP)

OMB: 0920-0020

IC ID: 183369

Information Collection (IC) Details

View Information Collection (IC)

Facility Certification Document
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CDC/NIOSH (M) 2.9 Miner Identification Document Form 2.9.pdf No No Paper Only
Form and Instruction CDC/NIOSH (M) 2.10 Coal Mine Operator's Plan Form 210.pdf No No Paper Only
Form and Instruction CDC/NIOSH (M) 2.11 Facility Certification Document Form 211.pdf No No Paper Only
Form 4 Facility Certification Document Attmt 7- CWHSP-Facility-2.11v2010.pdf No No Paper Only

Health Illness Prevention

0920-0149-Mortality Studies in Coal Mining, Metal and Non-Metal Mining and General Industry and 0920-0153- Mortality Studies in coal Mining, Metal and Non-Metal Mining and General Industry.  72 FR 42414

100 0
   
Individuals or Households
 
   0 %

  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 100 0 0 75 0 25
Annual IC Time Burden (Hours) 50 0 0 37 0 13
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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