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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.