Information Collection Request

Mine Rescue Teams; Arrangements for Emergency Medical Assistance; and Arrangements for Transportation for Injured Persons

ICR 201208-1219-006 · OMB 1219-0078 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 5000-3 Mine Rescue Teams; Arrangements for Emergency Medical Assistance; and Arrangements for Transportation for Injured Persons Form and Instruction Modified Available
1219-0078_Supporting_Statement_Final_02-08-13_for_ROCIS.doc Supporting Statement A Uploaded 2013-02-14 Available
1219-0078 60 Day PUBLISHED FRN 10-19-12 Vol 77 No 203 p 64360 .pdf Supplementary Document Uploaded 2012-12-20 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
14446 Mine Rescue Teams; Arrangements for Emergency Medical Assistance; and Arrangements for Transportation for Injured Persons Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2016 36 Months From Approved 03/31/2013
20,043 0 16,873
10,111 0 8,825
309,067 0 243,049





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Mine Rescue Teams; Arrangements for Emergency Medical Assistance; and Arrangements for Transportation for Injured Persons 5000-3 Certificate of Physical Qualification for Mine Rescue Work

table that charts list 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 20,043 16,873 0 0 3,170 0
Annual Time Burden (Hours) 10,111 8,825 0 0 1,286 0
Annual Cost Burden (Dollars) 309,067 243,049 0 0 66,018 0


Reginfo record details
  No