Notice of Alleged Safety and Health Hazards, OSHA-7 Form

Forms and Documents

Document Name	Status
Form OSHA-7 (Web versio Notice of Alleged Safety or Health Hazards, OSHA-7 Form Form and Instruction	Modified
SS_1218-0064_Amendment_07-13-11.doc Justification for No Material/Nonsubstantive Change	2011-07-13
SS_1218-0064 FINAL (03-17-11).doc Supporting Statement A	2011-03-17
Preclearance FRN 01-13-11.pdf Supplementary Document	2011-02-11
29 CFR 1903.11.pdf Supplementary Document	2011-02-11
29 U.S.C 657.pdf Supplementary Document	2008-01-07
29 U.S.C. 651.pdf Supplementary Document	2008-01-07

IC Document Collections

IC ID	Document Title	Status
13971	Notice of Alleged Safety or Health Hazards, OSHA-7 Form Form and Instruction	Modified

ICR Details

OMB Control No: 1218-0064	ICR Reference No: 201107-1218-001
Status: Historical Active	Previous ICR Reference No: 201102-1218-003
Agency/Subagency: DOL/OSHA	Agency Tracking No: 1218-0064(2011)
Title: Notice of Alleged Safety and Health Hazards, OSHA-7 Form
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/05/2011
	Date Received in OIRA: 07/13/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2014	05/31/2014	05/31/2014
Responses	50,715	0	50,715
Time Burden (Hours)	13,414	0	13,414
Cost Burden (Dollars)	1,116	0	1,116

---

Abstract: The OSHA-7 Form is used by OSHA personnel to report unhealthful and/or unsafe conditions in the workplace. The information is given to OSHA by employees who wish to report unhealthful and/or unsafe conditions at their place of employment. Employee reports are authorized by Section 8(f)(1) of the OSH Act. This information is used by OSHA to evaluate the alleged hazards and to schedule an inspection. The form is available in English and Spanish.

---

Authorizing Statute(s): US Code: 29 USC 651 Name of Law: Occupational Safety and Health Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 2417	01/13/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 17446	03/29/2011
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Notice of Alleged Safety or Health Hazards, OSHA-7 Form	OSHA-7 (Web version, Spanish), OSHA-7, OSHA-7 (Web version)	Notice of Alleged Safety or Health Hazards ,   Notice of Alleged Safety or Health Hazards (Spanish) ,   Notice of Alleged Safety and Health Hazards

---

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	50,715	50,715	0	0	0	0
Annual Time Burden (Hours)	13,414	13,414	0	0	0	0
Annual Cost Burden (Dollars)	1,116	1,116	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $375,270

Does this IC contain surveys, censuses, or employ statistical methods? No

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

---

Common Form ICR:  No

---

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: 07/13/2011

---