X-ray Coal Miners (CWHSP)

National Coal Workers' X-ray Surveillance Program (CWXSP) - Federal Mine Safety and Health Act 1977 (42CFR37)

OMB: 0920-0020

IC ID: 197450

Information Collection (IC) Details

View Information Collection (IC)

X-ray Coal Miners (CWHSP)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 5 Coal Workers' Health Surveillance Program (CWHSP)-Consent Release and History Form- Next of Kim (form 2.6) Attmt 9- CDC NIOSH 2.6 NCWAS Consent Release History Form 4.18.11.doc No No Paper Only
Form 6 Coal Workers' Health Surveillance Program (CWHSP)- Invoice-Pathologist Attmt 10- Pathologist Invoice Sample.pdf No No Paper Only
Form and Instruction 9 Coal Workers' Health Surveillance Program (CWHSP)- Report Pathologist Attmt 11- NCWAS checklist 4.18.11 (2).doc No No Paper Only

Health Immunization Management

 

5,000 0
   
Individuals or Households
 
   0 %

  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 5,000 0 0 0 0 5,000
Annual IC Time Burden (Hours) 1,250 0 0 0 0 1,250
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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