Resident Air Quality Monitoring

Adoption, Health Impact and Cost of Smoke-Free Multi-Unit Housing Policies

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1004 can be found here:

Documents and Forms

Document Name Document Type
Resident Air Quality Monitoring Form and Instruction
Air Quality Monitoring Protocol Att 11A_Protocol for Air Monitoring.doc Form and Instruction
Air Quality Monitoring Protocol - Spanish Att 11A-1(s)_Airborne Particle Data Diary_9 12 2012 .docx Form and Instruction
Att 11A-1(e)_Airborne Particle Data Diary_9 12 2012.doc Data Diary - English IC Document
Att 11A-1(s)_Airborne Particle Data Diary_9 12 2012 .docx Data Diary - Spanish IC Document

Information Collection (IC) Details

IC Title:	Resident Air Quality Monitoring	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	none	Air Quality Monitoring Protocol	Att 11A_Protocol for Air Monitoring.doc		No	No	Paper Only
Form and Instruction	none	Air Quality Monitoring Protocol - Spanish	Att 11A-1(s)_Airborne Particle Data Diary_9 12 2012 .docx		No	No	Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Data Diary - English	Att 11A-1(e)_Airborne Particle Data Diary_9 12 2012.doc	09/27/2012
Data Diary - Spanish	Att 11A-1(s)_Airborne Particle Data Diary_9 12 2012 .docx	09/27/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.