Information Collection

MUH Resident Air Quality Monitoring

IC 204448 under ICR 201309-0920-011 · OMB 0920-1004.

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.