Airborne Hazards And Open Burn Pit Registry Self-Assessment Questionnaire

Open Burn Pit Registry Web-accessible Self-Assessment/Questionnaire

OMB: 2900-0800

IC ID: 210929

Information Collection (IC) Details

View Information Collection (IC)

Airborne Hazards And Open Burn Pit Registry Self-Assessment Questionnaire
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form VA Form 10-10066 Airborne Hazards And Open Burn Pit Registry Self-Assessment Questionnaire VA Form 10-10066_Open Burn Pit Registry Self-Assessment Questionnaire_20140324.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

50,000 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 50,000 0 50,000 0 0 0
Annual IC Time Burden (Hours) 33,333 0 33,333 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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