Information Collection

Requesting Laboratory Input to Identify Gaps in Preparedness for Testing Environmental Samples

IC 217446 under ICR 201402-0920-004 · OMB 0920-0881.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0881 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Requesting Laboratory Input to Identify Gaps in Preparedness for Testing Environmental Samples	Form
BA Environmental Sample Processing Questionnaire Attach 1 Survey monkey file.docx	Form
SS A Data_Calls 7-16-15.doc Supporting Statement A	IC Document
SS B Supporting Statement rev 3.docx Supporting Statement B	IC Document

IC Title:

Requesting Laboratory Input to Identify Gaps in Preparedness for Testing Environmental Samples

Agency IC Tracking Number:

15AUN

IC Status: New

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
Form	none	BA Environmental Sample Processing Questionnaire	Attach 1 Survey monkey file.docx		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A	SS A Data_Calls 7-16-15.doc	07/16/2015
Supporting Statement B	SS B Supporting Statement rev 3.docx	07/16/2015

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