22.3 Survey

Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months and Sibling Birth Enrollment

DustWipeInorganicsInstrument

Environmental Sample Collection (Postnatal)

OMB: 0925-0593

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Download: docx | pdf

OMB #: 0925-0953

OMB Expiration Date: 8/31/2014

Dust Wipe-Inorganics Instrument, Phase 2g

OMB Specification


Dust Wipe-Inorganics Instrument


Event Category:

Time-Based

Event:

36M, 48M, 60M

Administration:

N/A

Instrument Target:

Child's Primary Residence

Instrument Respondent:

Primary Caregiver

Domain:

Environmental

Document Category:

Sample Collection

Method:

Data Collector Administered

Mode (for this instrument*):

In-Person, CAI

OMB Approved Modes:

In-Person, CAI

Estimated Administration Time:

1 minute

Multiple Child/Sibling Consideration:

Per Child

Special Considerations:

N/A

Version:

1.0

MDES Release:

4.0


*This instrument is OMB-approved for multi-mode administration, but this version of the instrument is designed for administration in this/these mode(s) only.


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Dust Wipe-Inorganics Instrument



TABLE OF CONTENTS





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Dust Wipe-Inorganics Instrument



GENERAL PROGRAMMER INSTRUCTIONS:

WHEN PROGRAMMING INSTRUMENTS, VALIDATE FIELD LENGTHS AND TYPES AGAINST THE MDES TO ENSURE DATA COLLECTION RESPONSES DO NOT EXCEED THOSE OF THE MDES. SOME GENERAL ITEM LIMITS USED ARE AS FOLLOWS:


DATA ELEMENT FIELDS

MAXIMUM CHARACTERS PERMITTED

DATA TYPE

PROGRAMMER INSTRUCTIONS

ADDRESS AND EMAIL FIELDS

100

CHARACTER


UNIT AND PHONE FIELDS

10

CHARACTER


_OTH AND COMMENT FIELDS

255

CHARACTER

  • Limit text to 255 characters

FIRST NAME AND LAST NAME

30

CHARACTER

  • Limit text to 30 characters

ALL ID FIELDS

36

CHARACTER


ZIP CODE

5

NUMERIC


ZIP CODE LAST FOUR

4

NUMERIC


CITY

50

CHARACTER


DOB AND ALL OTHER DATE FIELDS (E.G., DT, DATE, ETC.)

10

NUMERIC


CHARACTER

  • DISPLAY AS MM/DD/YYYY

  • STORE AS YYYY-MM-DD

  • HARD EDITS:

MM MUST EQUAL 01 TO 12

DD MUST EQUAL 01 TO 31

YYYY MUST BE BETWEEN 1900 AND CURRENT YEAR.

TIME VARIABLES

TWO-DIGIT HOUR AND TWO-DIGIT MINUTE, AM/PM DESIGNATION

NUMERIC

  • HARD EDITS:

HOURS MUST BE BETWEEN 00 AND 12;

MINUTES MUST BE BETWEEN 00 AND 59


Instrument Guidelines for Participant and Respondent IDs:

PRENATALLY, THE P_ID IN THE MDES HEADER IS THAT OF THE PARTICIPANT (E.G. THE NON-PREGNANT WOMAN, PREGNANT WOMAN, OR THE FATHER).


POSTNATALLY, A RESPONDENT ID WILL BE USED IN ADDITION TO THE PARTICIPANT ID BECAUSE SOMEBODY OTHER THAN THE PARTICIPANT MAY BE COMPLETING THE INTERVIEW. FOR EXAMPLE, THE PARTICIPANT MAY BE THE CHILD AND THE RESPONDENT MAY BE THE MOTHER, FATHER, OR ANOTHER CAREGIVER. THEREFORE, MDES VERSION 2.2 AND ALL FUTURE VERSIONS CONTAIN A R_P_ID (RESPONDENT PARTICIPANT ID) HEADER FIELD FOR EACH POST-BIRTH INSTRUMENT. THIS WILL ALLOW ROCs TO INDICATE WHETHER THE RESPONDENT IS SOMEBODY OTHER THAN THE PARTICIPANT ABOUT WHOM THE QUESTIONS ARE BEING ASKED.



A REMINDER:

ALL RESPONDENTS MUST BE CONSENTED AND HAVE RECORDS IN THE PERSON, PARTICIPANT, PARTICIPANT_CONSENT AND LINK_PERSON_PARTICIPANT TABLES, WHICH CAN BE PRELOADED INTO EACH INSTRUMENT. ADDITIONALLY, IN POST-BIRTH QUESTIONNAIRES WHERE THERE IS THE ABILITY TO LOOP THROUGH A SET OF QUESTIONS FOR MULTIPLE CHILDREN, IT IS IMPORTANT TO CAPTURE AND STORE THE CORRECT CHILD P_ID ALONG WITH THE LOOP INFORMATION. IN THE MDES VARIABLE LABEL/DEFINITION COLUMN, THIS IS INDICATED AS FOLLOWS: EXTERNAL IDENTIFIER: PARTICIPANT ID FOR CHILD DETAIL.





WIPE-INORGANICS INSTRUMENT-DATA COLLECTOR QUESTIONS


(TIME_STAMP_WIC_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.

  • PRELOAD DWELLING_UNIT_ID FOR THE DWELLING UNIT.

  • PRELOAD PARTICIPANT ID (P_ID) FOR CHILD AND RESPONDENT ID (R_P_ID) FOR CAREGIVER.

  • PRELOAD MULT_CHILD AND CHILD_NUM (IF MULT_CHILD = 1), FROM PVST INSTRUMENT.

  • IF MULT_CHILD = 1, PRELOAD CHILD_QNUM.


WIC01000/(STAFF_ID). ENTER STAFF ID

__________________________________________

STAFF ID


WIC02000/(WIPE_INORG_SAMPLES). WHICH WIPE-INORGANICS SAMPLES ARE SCHEDULED FOR THIS VISIT?


Label

Code

Go To

WIPE-ORGANICS PRIMARY ONLY

1

WIPE_INORG_OKAY

WIPE-INORGANICS PRIMARY AND QC SAMPLES

2



WIC03000/(WIPE_INORG_SUBSAMPLES). WHICH WIPE-INORGANICS QC SAMPLES ARE SCHEDULED FOR THIS VISIT?


DATA COLLECTOR INSTRUCTIONS

  • SELECT ALL THAT APPLY.


Label

Code

Go To

WIPE-INORGANICS BLANK

1


WIPE-INORGANICS DUPLICATE

2


WIPE-INORGANICS SPIKE

3



WIC04000/(WIPE_INORG_OKAY). We would like to collect a wipe sample from your home.  Is that okay?


Label

Code

Go To

YES

1

WIPE_INORG_COMMENTS

NO

2


REFUSED

-1


DON’T KNOW

-2



SOURCE

New


WIC05000/(WIPE_INORG_REFUSE). RECORD REASON FOR REFUSAL IF GIVEN.


Label

Code

Go To

NONE GIVEN

1

WIPE_INORG_COMMENTS

NOT INTERESTED IN WIPE SAMPLE COLLECTION

2

WIPE_INORG_COMMENTS

OTHER

-5



WIC06000/(WIPE_INORG_REFUSE_OTH). SPECIFY: _________________________________


SOURCE

New


PROGRAMMER INSTRUCTIONS

  • GO TO WIPE_INORG_COMMENTS.


WIC07000/(WIPE_INORG_COMMENTS). RECORD ANY COMMENTS ABOUT THE WIPE-INORGANICS SAMPLE COLLECTION:

 

COMMENTS:_____________________________________________________


(TIME_STAMP_WIC_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.

  • IF WIPE_INORG_OKAY= 2, -1, OR -2, GO TO TIME_STAMP_WSS_ET.

  • OTHERWISE, GO TO TIME_STAMP_WPS_ST.



WIPE-INORGANICS PRIMARY SAMPLE


(TIME_STAMP_WPS_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP


WPS01000. COLLECTION INSTRUCTIONS


DATA COLLECTOR INSTRUCTIONS

  • COLLECT THE WIPE-INORGANICS SAMPLE IN THE CENTER OF THE LARGEST OPEN AREA OF THE PARTICIPANT’S MOST USED ROOM IN ACCORDANCE WITH THE SOP.


WPS02000/(WIPE_INORG_COLLECT). WAS A WIPE-INORGANICS SAMPLE COLLECTED?


Label

Code

Go To

YES

1


NO

2



PROGRAMMER INSTRUCTIONS

  • IF WIPE_INORG_COLLECT= 1, SET SAMPLE_NUMBER = 1 AND GO TO WPS05000.

  • OTHERWISE, GO TO WIPE_INORG_NOTCOLLECT.


WPS03000/(WIPE_INORG_NOTCOLLECT). WHY WAS A WIPE-INORGANICS SAMPLE NOT COLLECTED?


Label

Code

Go To

KIT NOT AVAILABLE

1

WIPE_INORG_PRIM_COMMENTS

SUPPLIES PROBLEM

2

WIPE_INORG_PRIM_COMMENTS

RAN OUT OF TIME

3

WIPE_INORG_PRIM_COMMENTS

NOT ENOUGH SPACE

4

WIPE_INORG_PRIM_COMMENTS

REFUSAL

5

WIPE_INORG_PRIM_COMMENTS

OTHER

-5



WPS04000/(WIPE_INORG_NOTCOLLECT_OTH). SPECIFY: _______________________________


PROGRAMMER INSTRUCTIONS

  • GO TO WIPE_INORG_PRIM_COMMENTS.


WPS05000. DATE WIPE-INORGANICS SAMPLE COLLECTED:


(WIPE_INORG_COLL_MM) MONTH: |___|___|

              M    M


(WIPE_INORG_COLL_DD) DAY:       |___|___| 

                D    D


(WIPE_INORG_COLL_YYYY) YEAR:   

|___|___|___|___|

   Y    Y      Y     Y


PROGRAMMER INSTRUCTIONS

  • DISPLAY HARD EDIT IF MM, DD OR YYYY ARE OUTSIDE CRITERIA DEFINED IN GENERAL PROGRAMMER INSTRUCTIONS.


WPS06000/(SAMPLE_PR_ID). PRIMARY SAMPLE ID:

|E||__|__|__|__|__|__|__|-DN0

 WIPE-INORGANICS ID


DATA COLLECTOR INSTRUCTIONS

  • ENTER THE WIPE-INORGANICS PRIMARY SAMPLE ID ON THE SAMPLE ID LABEL.


PROGRAMMER INSTRUCTIONS

  • ID MUST BE FORMATTED WITH TWO ALPHA 7 NUMERIC DASH DN01.


WPS07000/(WIPE_INORG_ROOM). IN WHICH ROOM WAS THE WIPE-INORGANICS SAMPLE COLLECTED?


Label

Code

Go To

COMMON LIVING AREA

1

WIPE_INORG_SURF

CHILD’S BEDROOM

2

WIPE_INORG_SURF

MOTHER’S BEDROOM

3

WIPE_INORG_SURF

KITCHEN

4

WIPE_INORG_SURF

OTHER

-5



WPS08000/(WIPE_INORG_ROOM_OTH). SPECIFY: __________________________________________


WPS09000/(WIPE_INORG_SURF). WHAT TYPE OF SURFACE WAS WIPED WHEN COLLECTING THE WIPE-INORGANICS SAMPLE?


Label

Code

Go To

SMOOTH SURFACE

1

WIPE_INORG_SURF_MAT

ROUGH SURFACE

2

WIPE_INORG_SURF_MAT

OTHER

-5



WPS10000/(WIPE_INORG_SURF_OTH). SPECIFY: ____________________________________________


WPS11000/(WIPE_INORG_SURF_MAT). WHAT MATERIAL WAS THE SURFACE WIPED WHEN COLLECTING THE WIPE-INORGANICS SAMPLE


Label

Code

Go To

VINYL

1

WIPE_INORG_CENTER

LINOLEUM

2

WIPE_INORG_CENTER

WOOD

3

WIPE_INORG_CENTER

CORK

4

WIPE_INORG_CENTER

RUBBER

5

WIPE_INORG_CENTER

CONCRETE

6

WIPE_INORG_CENTER

PAINTED

7

WIPE_INORG_CENTER

TILE

8

WIPE_INORG_CENTER

HIGH-PILE RUG/CARPET (GREATER THAN OR EQUAL TO ½ in)

9

WIPE_INORG_CENTER

LOW-PILE RUG/CARPET (LESS THAN ½ in)

10

WIPE_INORG_CENTER

OTHER

-5



WPS12000/(WIPE_INORG_SURF_MAT_OTH). SPECIFY: ____________________________________________


WPS13000/(WIPE_INORG_CENTER). WAS THE WIPE-INORGANICS SAMPLE COLLECTED FROM THE CENTER OF THE LARGEST OPEN AREA?


Label

Code

Go To

YES

1

WIPE_INORG_PRIM_COMMENTS

NO

2



WPS14000/(WIPE_INORG_NOTCENTER). WHY WAS THE CENTER OF THE LARGEST AREA NOT WIPED?


Label

Code

Go To

AREA NOT AVAILABLE

1

WIPE_INORG_ROOM_AREA

LOCATION ALREADY SAMPLED

2

WIPE_INORG_ROOM_AREA

REFUSAL

3

WIPE_INORG_ROOM_AREA

OTHER

-5



WPS15000/(WIPE_INORG_NOTCENTER_OTH). SPECIFY: ____________________________________________


WPS16000/(WIPE_INORG_ROOM_AREA). WHERE IN THE ROOM WAS THE WIPE-INORGANICS SAMPLE COLLECTED?


Label

Code

Go To

LESS THAN ONE FOOT FROM WALL

1


ONE FOOT OR MORE FROM WALL, BUT NOT LARGEST OPEN AREA

2



WPS17000/(WIPE_INORG_PRIM_COMMENTS). RECORD ANY COMMENTS ABOUT THE WIPE-INORGANICS PRIMARY SAMPLE COLLECTION:

 

COMMENTS:                                                                                                  _


(TIME_STAMP_WPS_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP

  • IF WIPE_INORG_SAMPLES= 1 OR WIPE_INORG_COLLECT=2, GO TO TIME_STAMP_WSS_ET.

  • IF WIPE_INORG_COLLECT= 1 AND

    • IF WIPE_INORG_SUBSAMPLES= 2 ONLY, OR 2 AND 3, GO TO TIME_STAMP_WDS_ST.

    • IF WIPE_INORG_SUBSAMPLES= 3 ONLY, GO TO TIME_STAMP_WSS_ST.

    • IF WIPE_INORG_SUBSAMPLES= 1 ONLY, 1 AND 2, 1 AND 3 OR 1, 2 AND 3, GO TO TIME_STAMP_WBS_ST.



WIPE-INORGANICS BLANK SAMPLE


(TIME_STAMP_WBS_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP


WBS01000/(WIPE_INORG_BLANK_COLLECT). WAS THE WIPE-INORGANICS BLANK SAMPLE COLLECTED?


Label

Code

Go To

YES

1


NO

2



PROGRAMMER INSTRUCTIONS

  • IF WIPE_INORG_BLANK_COLLECT = 1, SET SAMPLE_NUMBER = 2 AND GO TO SAMPLE_BL_ID.

  • OTHERWISE, GO TO WIPE_INORG_BLANK_NOTCOLL.


WBS02000/(WIPE_INORG_BLANK_NOTCOLL). WHY WAS THE WIPE-INORGANICS BLANK SAMPLE NOT COLLECTED?


Label

Code

Go To

KIT NOT AVAILABLE

1

WIPE_INORG_BLANK_COMMENTS

SUPPLIES PROBLEM

2

WIPE_INORG_BLANK_COMMENTS

OUT OF TIME

3

WIPE_INORG_BLANK_COMMENTS

OTHER

-5



WBS03000/(WIPE_INORG_BLANK_NOTCOLL_OTH). SPECIFY: _____________________________


PROGRAMMER INSTRUCTIONS

  • GO TO WIPE_INORG_BLANK_COMMENTS.


WBS04000/(SAMPLE_BL_ID). BLANK SAMPLE ID:

|E||__|__|__|__|__|__|__|-DN01

WIPE-INORGANICS BLANK ID


DATA COLLECTOR INSTRUCTIONS

  • ENTER THE WIPE-INORGANICSBLANK SAMPLE ID ON THE SAMPLE ID LABEL.


PROGRAMMER INSTRUCTIONS

  • ID MUST BE FORMATTED WITH TWO ALPHA 7 NUMERIC DASH DN01.

  • DISPLAY SOFT EDIT IF SAMPLE_BL_ID = SAMPLE_PR_ID.


WBS05000/(WIPE_INORG_BLANK_COMMENTS). RECORD ANY COMMENTS ABOUT WIPE-INORGANICS BLANK SAMPLE COLLECTION:

 

COMMENTS: _____________________________________________________


(TIME_STAMP_WBS_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP

  • IF WIPE_INORG_COLLECT= 1 AND

    • IF WIPE_INORG_SUBSAMPLES = 1 ONLY, GO TO TIME_STAMP_WSS_ET.

    • IF WIPE_INORG_SUBSAMPLES= 1 AND 2, OR 1, 2, AND 3, GO TO TIME_STAMP_WDS_ST.

    • IF WIPE_INORG_SUBSAMPLES= 1 AND 3, GO TO TIME_STAMP_WSS_ST.



WIPE-INORGANIC DUPLICATE SAMPLE


(TIME_STAMP_WDS_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP


WDS01000/(WIPE_INORG_DUP_COLLECT). WAS A WIPE-INORGANICS DUPLICATE SAMPLE COLLECTED?


Label

Code

Go To

YES

1


NO

2



PROGRAMMER INSTRUCTIONS

  • IF WIPE_INORG_DUP_COLLECT= 1, SET SAMPLE_NUMBER = 3, AND GO TO SAMPLE_DP_ID.

  • OTHERWISE, GO TO WIPE_INORG_DUP_NOTCOLLECT.


WDS02000/(WIPE_INORG_DUP_NOTCOLLECT). WHY WAS THE WIPE-INORGANICS DUPLICATE SAMPLE NOT COLLECTED?


Label

Code

Go To

KIT NOT AVAILABLE

1

WIPE_INORG_DUP_COMMENTS

SUPPLIES PROBLEM

2

WIPE_INORG_DUP_COMMENTS

OUT OF TIME

3

WIPE_INORG_DUP_COMMENTS

NOT ENOUGH SPACE

4

WIPE_INORG_DUP_COMMENTS

REFUSAL

5

WIPE_INORG_DUP_COMMENTS

OTHER

-5



WDS03000/(WIPE_INORG_DUP_NOTCOLLECT_OTH). SPECIFY: ________________________________


PROGRAMMER INSTRUCTIONS

  • GO TO WIPE_INORG_DUP_COMMENTS.


WDS04000/(SAMPLE_DP_ID). DUPLICATE SAMPLE ID:

|E||__|__|__|__|__|__|__|-DN01

WIPE-INORGANICS DUPLICATE ID


DATA COLLECTOR INSTRUCTIONS

  • ENTER THE WIPE-INORGANICS DUPLICATE SAMPLE ID ON THE SAMPLE ID LABEL.


PROGRAMMER INSTRUCTIONS

  • ID MUST BE FORMATTED WITH TWO ALPHA 7 NUMERIC DASH DN01.

  • DISPLAY SOFT EDIT IF SAMPLE_DP_ID = SAMPLE_PR_ID AND/OR SAMPLE_BL_ID.


WDS05000/(WIPE_INORG_DUP_SURF). WHAT TYPE OF SURFACE WAS WIPED WHEN COLLECTING THE WIPE-INORGANICS DUPLICATE SAMPLE?


Label

Code

Go To

SMOOTH SURFACE

1

WIPE_INORG_DUP_SURF_MAT

ROUGH SURFACE

2

WIPE_INORG_DUP_SURF_MAT

OTHER

-5



WDS06000/(WIPE_INORG_ DUP_SURF_OTH). SPECIFY: ____________________________________________


WDS07000/(WIPE_INORG_DUP_SURF_MAT). WHAT MATERIAL WAS THE SURFACE WIPED WHEN COLLECTING THE WIPE-INORGANICS DUPLICATE SAMPLE


Label

Code

Go To

VINYL

1

WIPE_INORG_DUP_ROOM_AREA

LINOLEUM

2

WIPE_INORG_DUP_ROOM_AREA

WOOD

3

WIPE_INORG_DUP_ROOM_AREA

CORK

4

WIPE_INORG_DUP_ROOM_AREA

RUBBER

5

WIPE_INORG_DUP_ROOM_AREA

CONCRETE

6

WIPE_INORG_DUP_ROOM_AREA

PAINTED

7

WIPE_INORG_DUP_ROOM_AREA

TILE

8

WIPE_INORG_DUP_ROOM_AREA

HIGH-PILE RUG/CARPET (GREATER THAN OR EQUAL TO ½ in)

9

WIPE_INORG_DUP_ROOM_AREA

LOW-PILE RUG/CARPET (LESS THAN ½ in)

10

WIPE_INORG_DUP_ROOM_AREA

OTHER

-5



WDS08000/(WIPE_INORG_DUP_SURF_MAT_OTH). SPECIFY: ____________________________________________


WDS09000/(WIPE_INORG_DUP_ROOM_AREA). WHERE IN THE ROOM WAS THE WIPE-INORGANICS DUPLICATE SAMPLE COLLECTED?


Label

Code

Go To

LESS THAN ONE FOOT FROM WALL

1


ONE FOOT OR MORE FROM WALL, BUT NOT LARGEST OPEN AREA

2



WDS10000/(WIPE_INORG_DUP_COMMENTS). RECORD ANY COMMENTS ABOUT THE WIPE-INORGANICS DUPLICATE SAMPLE COLLECTION:

 

COMMENTS: _____________________________________________________


(TIME_STAMP_WDS_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP

  • IF WIPE_INORG_COLLECT= 1 AND

    • IF WIPE_INORG_SUBSAMPLES = 2, OR 1 AND 2, GO TO TIME_STAMP_WSS_ET.

    • IF WIPE_INORG_SUBSAMPLES= 2 AND 3, OR 1, 2, AND 3, GO TO TIME_STAMP_WSS_ST.



WIPE-INORGANICS SPIKE SAMPLE


(TIME_STAMP_WSS_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP


WSS01000/(WIPE_INORG_SPIKE_COLLECT). WAS THE WIPE-INORGANICS SPIKE SAMPLE INCLUDED?


Label

Code

Go To

YES

1


NO

2



PROGRAMMER INSTRUCTIONS

  • IF WIPE_INORG_SPIKE_COLLECT= 1, SET SAMPLE_NUMBER ­= 4 AND GO TO SAMPLE_SP_ID.

  • OTHERWISE, GO TO WIPE_INORG_SPIKE_NOTCOLL.


WSS02000/(WIPE_INORG_SPIKE_NOTCOLL). WHY WAS THE WIPE-INORGANICS SPIKE SAMPLE NOT INCLUDED?


Label

Code

Go To

SPIKE NOT AVAILABLE

1

WIPE_INORG_SPIKE_COMMENTS

OUT OF TIME

2

WIPE_INORG_SPIKE_COMMENTS

OTHER

-5



WSS03000/(WIPE_INORG_SPIKE_NOTCOLL_OTH). SPECIFY: ______________________________


PROGRAMMER INSTRUCTIONS

  • GO TO WIPE_INORG_SPIKE_COMMENTS.


WSS04000/(SAMPLE_SP_ID). SPIKE SAMPLE ID:

|E||__|__|__|__|__|__|__|-DN01

 WIPE-INORGANICS SPIKE ID


DATA COLLECTOR INSTRUCTIONS

  • ENTER THE WIPE-INORGANICSSPIKE SAMPLE ID ON THE SAMPLE ID LABEL.


PROGRAMMER INSTRUCTIONS

  • ID MUST BE FORMATTED WITH TWO ALPHA 7 NUMERIC DASH DN01.

  • DISPLAY SOFT EDIT IF SAMPLE_SP_ID = SAMPLE_PR_ID, SAMPLE_BL_ID AND/OR SAMPLE_DP_ID.


WSS05000/(WIPE_INORG_SPIKE_COMMENTS). RECORD ANY COMMENTS ABOUT THE WIPE-INORGANICS SPIKE SAMPLE COLLECTION:

 

COMMENTS: _____________________________________________________


(TIME_STAMP_WSS_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP


Public reporting burden for this collection of information is estimated to average 1 minute per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0593*).  Do not return the completed form to this address.

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