Information Collection

DOC NEPA Environmental Questionnaire and Checklist

IC 191361 under ICR 201404-0690-001 · OMB 0690-0028.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0690-0028 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CD-593 DOC NEPA Environmental Questionnaire and Checklist	Form and Instruction
CD-593 U.S. DOC National Environmental Policy Act Environmental NEPA.EQChecklist.REV.042414.docx	Form and Instruction

IC Title:

DOC NEPA Environmental Questionnaire and Checklist

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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 and Instruction	CD-593	U.S. DOC National Environmental Policy Act Environmental Questionnaire and Checklist	NEPA.EQChecklist.REV.042414.docx		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,000	800	200
Annual IC Time Burden (Hours)	3,000	2,600	400
Annual IC Cost Burden (Dollars)	1,000	1,000	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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