Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (New)

Forms and Documents

Document Name	Status
Form EPA202k09002 Tribes Training Evaluation Form	New
Generic Clearance Submission Template.doc Supplementary Document	2011-09-08
2434ss01b.docx Supporting Statement B	2011-09-08
2434ss01.docx Supporting Statement A	2011-09-08

IC Document Collections

IC ID	Document Title	Status
212399	ChemView Survey Other-Other	New
212084	Hypoxia Survey Other-Other	New
211430	TRI Conference Other-Other	New
210423	ToxCast Phase II Event Survey Other-Other	New
208186	Picturing Survey Other-Other	New
207766	PPRC Survey Other-Other	New
206925	Tanks Sessions Survey Other-Other	New
206913	OEI Vendor Day Survey Other-Other	New
206846	Tanks Survey Other-survey paper	New
206763	P2RX Survey Other-Other	New
206745	EnviroAtlas Survey Other-Other	New
204834	Tribes Training Evaluation Form	New
204453	OSWER Community Engagement Survey Other-Other	New
204124	My Air My Health Survey Other-Other	New
204006	CDX Help Desk Survey Other-Other	New
203869	CDX Satisfaction Survey Other-Other	New
203809	Lean Survey Other-Internet Survey	New
202783	Pollution Prevention Survey Other-Other	New
202352	Barnegat Bay Festival Survey Other-Other	New
201844	Vendor Day Survey Other-Online Survey	New
200157	Envirofacts Website Survey Other-Survey	New
199644	WEFTEC Conference Survey Other-Survey	New

ICR Details

OMB Control No: 2010-0042	ICR Reference No: 201106-2010-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: EPA/OP	Agency Tracking No: 2434.01
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (New)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/28/2011
	Date Received in OIRA: 06/09/2011
Terms of Clearance: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2014	36 Months From Approved
Responses	5,240	0	0
Time Burden (Hours)	1,386	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable the EPA to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 80542	12/22/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 33273	06/08/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 22

IC Title	Form No.	Form Name
PPRC Survey
Barnegat Bay Festival Survey
OSWER Community Engagement Survey
CDX Satisfaction Survey
P2RX Survey
EnviroAtlas Survey
Pollution Prevention Survey
WEFTEC Conference Survey
Vendor Day Survey
My Air My Health Survey
Tanks Survey
ToxCast Phase II Event Survey
TRI Conference
Lean Survey
Envirofacts Website Survey
Hypoxia Survey
Picturing Survey
Tanks Sessions Survey
OEI Vendor Day Survey
CDX Help Desk Survey
ChemView Survey
Tribes Training Evaluation	EPA202k09002	Training Evaluation Form

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	5,240	0	0	5,240	0	0
Annual Time Burden (Hours)	1,386	0	0	1,386	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new ICR, intended to replace the currently approved ICR 2090-0019, in order to implement OMB's new expedited approval process.

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Annual Cost to Federal Government: $200,103

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/08/2011

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