MUH Resident Air Quality Monitoring

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

Documents and Forms

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

Information Collection (IC) Details

IC Title:	MUH Resident Air Quality Monitoring	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Att 11A-1(s)_Airborne Particle Data Diary_9 12 2012 .docx		No	No	Printable Only
Instruction			Att 11A-1(e)_Airborne Particle Data Diary_9 12 2012.doc		No	No	Printable 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 %

	Approved	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
Air Monitoring Protocol	Att 11A_Protocol for Air Monitoring.doc	09/23/2013

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