Description of Collection Forms

1910-5122 #12 Response Final-5-13-13.xls

Human Reliability Program

Description of Collection Forms

OMB: 1910-5122

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OMB 1910-5122: Human Reliability Program -- Detail for Item 12 (Supporting Statement)

No. Collection Title FY 2009 Estimated Annual Respondents FY 2009Estimated Annual Responses Approximate Time to Complete Each Response FY 2009 Estimated Annual Burden Hours FY 2012 Estimated Annual Respondents FY 2012 Estimated Annual Responses % Submitted Electronically Approximate Time to Complete Each Response FY 2012 Estimated Annual Burden Hours Changes in Estimated Annual Hours (E-J) Main Factors for Changes
1 DOE F 470.3, Human Reliability Program (HRP) Certification 10,340 10,340 6 minutes 6,204 9,455 9,472 0.0% 10 minutes 1,479 4,725 Changed from 6 minutes to 10 minutes due to average time based on comments from the DOE field offices responsible for administering responses.
2 DOE F 470.4, Acknowledgement and Agreement to Participate in the Human Reliability Program (HRP) 10,340 10,340 6 minutes 6,204 9,094 9,105 0.0% 2 minutes 455 5,749 Changed from 6 minutes to 2 minutes due to average time based on comments from the DOE field offices responsible for administering responses.
3 DOE 470.5, Authorization and consent to release Human Reliability Program (HRP) Records in Connection with the HRP 10,340 10,340 6 minutes 6,204 9,094 9,105 0.0% 2 minutes 306 5,898 Changed from 6 minutes to 2 minutes due to average time based on comments from the DOE field offices responsible for administering responses.
4 DOE F 470.6, Refusal of Consent 10,340 10,340 6 minutes 6,204 0 0 0.0% 6 minutes 0 6,204 See Below
5 DOE F 470.7, Human Reliability Program (HRP) Alcohol Testing Form 10,340 10,340 6 minutes 6,204 16,317 16,317 0.0% 6 minutes 1,633 4,571

Totals 51,700 51,700
31,020 43,960 43,999

3,873 27,148













The HRP program has been in existence since 2004 and a more precise determination as to the number of respondents has been made. This has led to a reduction of approximately 7740 total numbers of respondents since 2009. Likewise, the total number of annual hours required for the collection has been reduced (27,148) based upon actual experience in the administration of the program over the previous three years. Using these calculations, the consolidated annual burden of this package is 3873 hours. The total number of respondents for Number 4. Refusal of Consent was zero for completion. The refusal negates to non participation in the program. Past years of reporting was incorrect.















































































File Typeapplication/vnd.ms-excel
Authorbrenda scheel
Last Modified Byfelecia briggs
File Modified2013-05-16
File Created2005-04-12

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