Assessing the Safety Culture of Underground Coal Mining Survey

Assessing the Safety Culture of Underground Coal Mining

Documents and Forms

Document Name Document Type
Attachment C1 - Oral Consent Script Survey 10 9 12.doc Other-Oral Consent Script-Survey
Attachment D - Instructions to Respondents 7.24.12.doc Instruction
Demographic Sheet Attachment C6- Demographic Sheet.doc Form
Safety Culture Survey Attachment C5 - Safety Culture Survey 7.24.12.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Assessing the Safety Culture of Underground Coal Mining Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Oral Consent Script-Survey			Attachment C1 - Oral Consent Script Survey 10 9 12.doc	No	No	Paper Only
Instruction			Attachment D - Instructions to Respondents 7.24.12.doc	No	No	Paper Only
Form	None	Demographic Sheet	Attachment C6- Demographic Sheet.doc	No	No	Paper Only
Form and Instruction	None	Safety Culture Survey	Attachment C5 - Safety Culture Survey 7.24.12.doc	No	No	Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,144	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,144	244	900
Annual IC Time Burden (Hours)	381	81	300
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.