Information Collection

Gas Pipeline Safety Program Certification and Hazardous Liquid Pipeline Safety Program Certification

IC 26791 under ICR 201203-2137-001 · OMB 2137-0584.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2137-0584 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PHMSA F 999-95 2012 Hazardous Liquid Base Grant Progress Report (Certification) Gas Pipeline Safety Program Certification and Hazardous Liquid Pipeline Safety Program Certification	Form and Instruction
Form PHMSA F 999-92 2012 Natural Gas Base Grant Progress Report (Certification) Gas Pipeline Safety Program Certification and Hazardous Liquid Pipeline Safety Program Certification	Form and Instruction
PHMSA F 999-95 2012 Hazardous Liquid Base Grant Progress Report (Certif HLBlankcert.pdf	Form and Instruction
PHMSA F 999-92 2012 Natural Gas Base Grant Progress Report (Certificati NGBlankcert.pdf	Form and Instruction

IC Title:

Gas Pipeline Safety Program Certification and Hazardous Liquid Pipeline Safety Program Certification

Agency IC Tracking Number:

2137-0584 Renewal

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR Part 198 (To search for a specific CFR, visit the Code of Federal Regulations.)

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	PHMSA F 999-95				Yes	No	Fillable Printable
Form and Instruction	PHMSA F 999-92				Yes	No	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 67

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	67	67
Annual IC Time Burden (Hours)	3,920	3,920
Annual IC Cost Burden (Dollars)	0	0

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.

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