22.3 Survey

OMB #: 0925-0953

OMB Expiration Date: 8/31/2014

Dust Wipe-Inorganics Instrument, Phase 2g

OMB Specification

Dust Wipe-Inorganics Instrument

Event Category:	Time-Based
Event:	36M, 48M, 60M
Administration:	N/A
Instrument Target:	Child's Primary Residence
Instrument Respondent:	Primary Caregiver
Domain:	Environmental
Document Category:	Sample Collection
Method:	Data Collector Administered
Mode (for this instrument*):	In-Person, CAI
OMB Approved Modes:	In-Person, CAI
Estimated Administration Time:	1 minute
Multiple Child/Sibling Consideration:	Per Child
Special Considerations:	N/A
Version:	1.0
MDES Release:	4.0

*This instrument is OMB-approved for multi-mode administration, but this version of the instrument is designed for administration in this/these mode(s) only.

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Dust Wipe-Inorganics Instrument

TABLE OF CONTENTS

GENERAL PROGRAMMER INSTRUCTIONS: 1

WIPE-INORGANICS INSTRUMENT-DATA COLLECTOR QUESTIONS 3

WIPE-INORGANICS PRIMARY SAMPLE 5

WIPE-INORGANICS BLANK SAMPLE 9

WIPE-INORGANIC DUPLICATE SAMPLE 11

WIPE-INORGANICS SPIKE SAMPLE 14

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Dust Wipe-Inorganics Instrument

GENERAL PROGRAMMER INSTRUCTIONS:

WHEN PROGRAMMING INSTRUMENTS, VALIDATE FIELD LENGTHS AND TYPES AGAINST THE MDES TO ENSURE DATA COLLECTION RESPONSES DO NOT EXCEED THOSE OF THE MDES. SOME GENERAL ITEM LIMITS USED ARE AS FOLLOWS:

DATA ELEMENT FIELDS	MAXIMUM CHARACTERS PERMITTED	DATA TYPE	PROGRAMMER INSTRUCTIONS
ADDRESS AND EMAIL FIELDS	100	CHARACTER
UNIT AND PHONE FIELDS	10	CHARACTER
_OTH AND COMMENT FIELDS	255	CHARACTER	Limit text to 255 characters
FIRST NAME AND LAST NAME	30	CHARACTER	Limit text to 30 characters
ALL ID FIELDS	36	CHARACTER
ZIP CODE	5	NUMERIC
ZIP CODE LAST FOUR	4	NUMERIC
CITY	50	CHARACTER
DOB AND ALL OTHER DATE FIELDS (E.G., DT, DATE, ETC.)	10	NUMERIC CHARACTER	DISPLAY AS MM/DD/YYYY STORE AS YYYY-MM-DD HARD EDITS: MM MUST EQUAL 01 TO 12 DD MUST EQUAL 01 TO 31 YYYY MUST BE BETWEEN 1900 AND CURRENT YEAR.
TIME VARIABLES	TWO-DIGIT HOUR AND TWO-DIGIT MINUTE, AM/PM DESIGNATION	NUMERIC	HARD EDITS: HOURS MUST BE BETWEEN 00 AND 12; MINUTES MUST BE BETWEEN 00 AND 59

Instrument Guidelines for Participant and Respondent IDs:

PRENATALLY, THE P_ID IN THE MDES HEADER IS THAT OF THE PARTICIPANT (E.G. THE NON-PREGNANT WOMAN, PREGNANT WOMAN, OR THE FATHER).

POSTNATALLY, A RESPONDENT ID WILL BE USED IN ADDITION TO THE PARTICIPANT ID BECAUSE SOMEBODY OTHER THAN THE PARTICIPANT MAY BE COMPLETING THE INTERVIEW. FOR EXAMPLE, THE PARTICIPANT MAY BE THE CHILD AND THE RESPONDENT MAY BE THE MOTHER, FATHER, OR ANOTHER CAREGIVER. THEREFORE, MDES VERSION 2.2 AND ALL FUTURE VERSIONS CONTAIN A R_P_ID (RESPONDENT PARTICIPANT ID) HEADER FIELD FOR EACH POST-BIRTH INSTRUMENT. THIS WILL ALLOW ROCs TO INDICATE WHETHER THE RESPONDENT IS SOMEBODY OTHER THAN THE PARTICIPANT ABOUT WHOM THE QUESTIONS ARE BEING ASKED.

A REMINDER:

ALL RESPONDENTS MUST BE CONSENTED AND HAVE RECORDS IN THE PERSON, PARTICIPANT, PARTICIPANT_CONSENT AND LINK_PERSON_PARTICIPANT TABLES, WHICH CAN BE PRELOADED INTO EACH INSTRUMENT. ADDITIONALLY, IN POST-BIRTH QUESTIONNAIRES WHERE THERE IS THE ABILITY TO LOOP THROUGH A SET OF QUESTIONS FOR MULTIPLE CHILDREN, IT IS IMPORTANT TO CAPTURE AND STORE THE CORRECT CHILD P_ID ALONG WITH THE LOOP INFORMATION. IN THE MDES VARIABLE LABEL/DEFINITION COLUMN, THIS IS INDICATED AS FOLLOWS: EXTERNAL IDENTIFIER: PARTICIPANT ID FOR CHILD DETAIL.

WIPE-INORGANICS INSTRUMENT-DATA COLLECTOR QUESTIONS

(TIME_STAMP_WIC_ST).

PROGRAMMER INSTRUCTIONS

• INSERT DATE/TIME STAMP.

• PRELOAD DWELLING_UNIT_ID FOR THE DWELLING UNIT.

• PRELOAD PARTICIPANT ID (P_ID) FOR CHILD AND RESPONDENT ID (R_P_ID) FOR CAREGIVER.

• PRELOAD MULT_CHILD AND CHILD_NUM (IF MULT_CHILD = 1), FROM PVST INSTRUMENT.

• IF MULT_CHILD = 1, PRELOAD CHILD_QNUM.

WIC01000/(STAFF_ID). ENTER STAFF ID

__________________________________________

STAFF ID

WIC02000/(WIPE_INORG_SAMPLES). WHICH WIPE-INORGANICS SAMPLES ARE SCHEDULED FOR THIS VISIT?

Label	Code	Go To
WIPE-ORGANICS PRIMARY ONLY	1	WIPE_INORG_OKAY
WIPE-INORGANICS PRIMARY AND QC SAMPLES	2

WIC03000/(WIPE_INORG_SUBSAMPLES). WHICH WIPE-INORGANICS QC SAMPLES ARE SCHEDULED FOR THIS VISIT?

DATA COLLECTOR INSTRUCTIONS

• SELECT ALL THAT APPLY.

Label	Code	Go To
WIPE-INORGANICS BLANK	1
WIPE-INORGANICS DUPLICATE	2
WIPE-INORGANICS SPIKE	3

WIC04000/(WIPE_INORG_OKAY). We would like to collect a wipe sample from your home.  Is that okay?

Label	Code	Go To
YES	1	WIPE_INORG_COMMENTS
NO	2
REFUSED	-1
DON’T KNOW	-2

SOURCE

New

WIC05000/(WIPE_INORG_REFUSE). RECORD REASON FOR REFUSAL IF GIVEN.

Label	Code	Go To
NONE GIVEN	1	WIPE_INORG_COMMENTS
NOT INTERESTED IN WIPE SAMPLE COLLECTION	2	WIPE_INORG_COMMENTS
OTHER	-5

WIC06000/(WIPE_INORG_REFUSE_OTH). SPECIFY: _________________________________

SOURCE

New

PROGRAMMER INSTRUCTIONS

• GO TO WIPE_INORG_COMMENTS.

WIC07000/(WIPE_INORG_COMMENTS). RECORD ANY COMMENTS ABOUT THE WIPE-INORGANICS SAMPLE COLLECTION:

 

COMMENTS:_____________________________________________________

(TIME_STAMP_WIC_ET).

PROGRAMMER INSTRUCTIONS

• INSERT DATE/TIME STAMP.

• IF WIPE_INORG_OKAY= 2, -1, OR -2, GO TO TIME_STAMP_WSS_ET.

• OTHERWISE, GO TO TIME_STAMP_WPS_ST.

WIPE-INORGANICS PRIMARY SAMPLE

(TIME_STAMP_WPS_ST).

PROGRAMMER INSTRUCTIONS

• INSERT DATE/TIME STAMP

WPS01000. COLLECTION INSTRUCTIONS

DATA COLLECTOR INSTRUCTIONS

• COLLECT THE WIPE-INORGANICS SAMPLE IN THE CENTER OF THE LARGEST OPEN AREA OF THE PARTICIPANT’S MOST USED ROOM IN ACCORDANCE WITH THE SOP.

WPS02000/(WIPE_INORG_COLLECT). WAS A WIPE-INORGANICS SAMPLE COLLECTED?

Label	Code	Go To
YES	1
NO	2

PROGRAMMER INSTRUCTIONS

• IF WIPE_INORG_COLLECT= 1, SET SAMPLE_NUMBER = 1 AND GO TO WPS05000.

• OTHERWISE, GO TO WIPE_INORG_NOTCOLLECT.

WPS03000/(WIPE_INORG_NOTCOLLECT). WHY WAS A WIPE-INORGANICS SAMPLE NOT COLLECTED?

Label	Code	Go To
KIT NOT AVAILABLE	1	WIPE_INORG_PRIM_COMMENTS
SUPPLIES PROBLEM	2	WIPE_INORG_PRIM_COMMENTS
RAN OUT OF TIME	3	WIPE_INORG_PRIM_COMMENTS
NOT ENOUGH SPACE	4	WIPE_INORG_PRIM_COMMENTS
REFUSAL	5	WIPE_INORG_PRIM_COMMENTS
OTHER	-5

WPS04000/(WIPE_INORG_NOTCOLLECT_OTH). SPECIFY: _______________________________

PROGRAMMER INSTRUCTIONS

• GO TO WIPE_INORG_PRIM_COMMENTS.

WPS05000. DATE WIPE-INORGANICS SAMPLE COLLECTED:

(WIPE_INORG_COLL_MM) MONTH: |___|___|

              M    M

(WIPE_INORG_COLL_DD) DAY:       |___|___| 

                D    D

(WIPE_INORG_COLL_YYYY) YEAR:   

|___|___|___|___|

   Y    Y      Y     Y

PROGRAMMER INSTRUCTIONS

• DISPLAY HARD EDIT IF MM, DD OR YYYY ARE OUTSIDE CRITERIA DEFINED IN GENERAL PROGRAMMER INSTRUCTIONS.

WPS06000/(SAMPLE_PR_ID). PRIMARY SAMPLE ID:

|E||__|__|__|__|__|__|__|-DN0

 WIPE-INORGANICS ID

DATA COLLECTOR INSTRUCTIONS

• ENTER THE WIPE-INORGANICS PRIMARY SAMPLE ID ON THE SAMPLE ID LABEL.

PROGRAMMER INSTRUCTIONS

• ID MUST BE FORMATTED WITH TWO ALPHA 7 NUMERIC DASH DN01.

WPS07000/(WIPE_INORG_ROOM). IN WHICH ROOM WAS THE WIPE-INORGANICS SAMPLE COLLECTED?

Label	Code	Go To
COMMON LIVING AREA	1	WIPE_INORG_SURF
CHILD’S BEDROOM	2	WIPE_INORG_SURF
MOTHER’S BEDROOM	3	WIPE_INORG_SURF
KITCHEN	4	WIPE_INORG_SURF
OTHER	-5

WPS08000/(WIPE_INORG_ROOM_OTH). SPECIFY: __________________________________________

WPS09000/(WIPE_INORG_SURF). WHAT TYPE OF SURFACE WAS WIPED WHEN COLLECTING THE WIPE-INORGANICS SAMPLE?

Label	Code	Go To
SMOOTH SURFACE	1	WIPE_INORG_SURF_MAT
ROUGH SURFACE	2	WIPE_INORG_SURF_MAT
OTHER	-5

WPS10000/(WIPE_INORG_SURF_OTH). SPECIFY: ____________________________________________

WPS11000/(WIPE_INORG_SURF_MAT). WHAT MATERIAL WAS THE SURFACE WIPED WHEN COLLECTING THE WIPE-INORGANICS SAMPLE

Label	Code	Go To
VINYL	1	WIPE_INORG_CENTER
LINOLEUM	2	WIPE_INORG_CENTER
WOOD	3	WIPE_INORG_CENTER
CORK	4	WIPE_INORG_CENTER
RUBBER	5	WIPE_INORG_CENTER
CONCRETE	6	WIPE_INORG_CENTER
PAINTED	7	WIPE_INORG_CENTER
TILE	8	WIPE_INORG_CENTER
HIGH-PILE RUG/CARPET (GREATER THAN OR EQUAL TO ½ in)	9	WIPE_INORG_CENTER
LOW-PILE RUG/CARPET (LESS THAN ½ in)	10	WIPE_INORG_CENTER
OTHER	-5

WPS12000/(WIPE_INORG_SURF_MAT_OTH). SPECIFY: ____________________________________________

WPS13000/(WIPE_INORG_CENTER). WAS THE WIPE-INORGANICS SAMPLE COLLECTED FROM THE CENTER OF THE LARGEST OPEN AREA?

Label	Code	Go To
YES	1	WIPE_INORG_PRIM_COMMENTS
NO	2

WPS14000/(WIPE_INORG_NOTCENTER). WHY WAS THE CENTER OF THE LARGEST AREA NOT WIPED?

Label	Code	Go To
AREA NOT AVAILABLE	1	WIPE_INORG_ROOM_AREA
LOCATION ALREADY SAMPLED	2	WIPE_INORG_ROOM_AREA
REFUSAL	3	WIPE_INORG_ROOM_AREA
OTHER	-5

WPS15000/(WIPE_INORG_NOTCENTER_OTH). SPECIFY: ____________________________________________

WPS16000/(WIPE_INORG_ROOM_AREA). WHERE IN THE ROOM WAS THE WIPE-INORGANICS SAMPLE COLLECTED?

Label	Code	Go To
LESS THAN ONE FOOT FROM WALL	1
ONE FOOT OR MORE FROM WALL, BUT NOT LARGEST OPEN AREA	2

WPS17000/(WIPE_INORG_PRIM_COMMENTS). RECORD ANY COMMENTS ABOUT THE WIPE-INORGANICS PRIMARY SAMPLE COLLECTION:

 

COMMENTS:                                                                                                  _

(TIME_STAMP_WPS_ET).

PROGRAMMER INSTRUCTIONS

• INSERT DATE/TIME STAMP

• IF WIPE_INORG_SAMPLES= 1 OR WIPE_INORG_COLLECT=2, GO TO TIME_STAMP_WSS_ET.

• IF WIPE_INORG_COLLECT= 1 AND
  
  

• IF WIPE_INORG_SUBSAMPLES= 2 ONLY, OR 2 AND 3, GO TO TIME_STAMP_WDS_ST.

• IF WIPE_INORG_SUBSAMPLES= 3 ONLY, GO TO TIME_STAMP_WSS_ST.

• IF WIPE_INORG_SUBSAMPLES= 1 ONLY, 1 AND 2, 1 AND 3 OR 1, 2 AND 3, GO TO TIME_STAMP_WBS_ST.

WIPE-INORGANICS BLANK SAMPLE

(TIME_STAMP_WBS_ST).

PROGRAMMER INSTRUCTIONS

• INSERT DATE/TIME STAMP

WBS01000/(WIPE_INORG_BLANK_COLLECT). WAS THE WIPE-INORGANICS BLANK SAMPLE COLLECTED?

Label	Code	Go To
YES	1
NO	2

PROGRAMMER INSTRUCTIONS

• IF WIPE_INORG_BLANK_COLLECT = 1, SET SAMPLE_NUMBER = 2 AND GO TO SAMPLE_BL_ID.

• OTHERWISE, GO TO WIPE_INORG_BLANK_NOTCOLL.

WBS02000/(WIPE_INORG_BLANK_NOTCOLL). WHY WAS THE WIPE-INORGANICS BLANK SAMPLE NOT COLLECTED?

Label	Code	Go To
KIT NOT AVAILABLE	1	WIPE_INORG_BLANK_COMMENTS
SUPPLIES PROBLEM	2	WIPE_INORG_BLANK_COMMENTS
OUT OF TIME	3	WIPE_INORG_BLANK_COMMENTS
OTHER	-5

WBS03000/(WIPE_INORG_BLANK_NOTCOLL_OTH). SPECIFY: _____________________________

PROGRAMMER INSTRUCTIONS

• GO TO WIPE_INORG_BLANK_COMMENTS.

WBS04000/(SAMPLE_BL_ID). BLANK SAMPLE ID:

|E||__|__|__|__|__|__|__|-DN01

WIPE-INORGANICS BLANK ID

DATA COLLECTOR INSTRUCTIONS

• ENTER THE WIPE-INORGANICSBLANK SAMPLE ID ON THE SAMPLE ID LABEL.

PROGRAMMER INSTRUCTIONS

• ID MUST BE FORMATTED WITH TWO ALPHA 7 NUMERIC DASH DN01.

• DISPLAY SOFT EDIT IF SAMPLE_BL_ID = SAMPLE_PR_ID.

WBS05000/(WIPE_INORG_BLANK_COMMENTS). RECORD ANY COMMENTS ABOUT WIPE-INORGANICS BLANK SAMPLE COLLECTION:

 

COMMENTS: _____________________________________________________

(TIME_STAMP_WBS_ET).

PROGRAMMER INSTRUCTIONS

• INSERT DATE/TIME STAMP

• IF WIPE_INORG_COLLECT= 1 AND
  
  

• IF WIPE_INORG_SUBSAMPLES = 1 ONLY, GO TO TIME_STAMP_WSS_ET.

• IF WIPE_INORG_SUBSAMPLES= 1 AND 2, OR 1, 2, AND 3, GO TO TIME_STAMP_WDS_ST.

• IF WIPE_INORG_SUBSAMPLES= 1 AND 3, GO TO TIME_STAMP_WSS_ST.

WIPE-INORGANIC DUPLICATE SAMPLE

(TIME_STAMP_WDS_ST).

PROGRAMMER INSTRUCTIONS

• INSERT DATE/TIME STAMP

WDS01000/(WIPE_INORG_DUP_COLLECT). WAS A WIPE-INORGANICS DUPLICATE SAMPLE COLLECTED?

Label	Code	Go To
YES	1
NO	2

PROGRAMMER INSTRUCTIONS

• IF WIPE_INORG_DUP_COLLECT= 1, SET SAMPLE_NUMBER = 3, AND GO TO SAMPLE_DP_ID.

• OTHERWISE, GO TO WIPE_INORG_DUP_NOTCOLLECT.

WDS02000/(WIPE_INORG_DUP_NOTCOLLECT). WHY WAS THE WIPE-INORGANICS DUPLICATE SAMPLE NOT COLLECTED?

Label	Code	Go To
KIT NOT AVAILABLE	1	WIPE_INORG_DUP_COMMENTS
SUPPLIES PROBLEM	2	WIPE_INORG_DUP_COMMENTS
OUT OF TIME	3	WIPE_INORG_DUP_COMMENTS
NOT ENOUGH SPACE	4	WIPE_INORG_DUP_COMMENTS
REFUSAL	5	WIPE_INORG_DUP_COMMENTS
OTHER	-5

WDS03000/(WIPE_INORG_DUP_NOTCOLLECT_OTH). SPECIFY: ________________________________

PROGRAMMER INSTRUCTIONS

• GO TO WIPE_INORG_DUP_COMMENTS.

WDS04000/(SAMPLE_DP_ID). DUPLICATE SAMPLE ID:

|E||__|__|__|__|__|__|__|-DN01

WIPE-INORGANICS DUPLICATE ID

DATA COLLECTOR INSTRUCTIONS

• ENTER THE WIPE-INORGANICS DUPLICATE SAMPLE ID ON THE SAMPLE ID LABEL.

PROGRAMMER INSTRUCTIONS

• ID MUST BE FORMATTED WITH TWO ALPHA 7 NUMERIC DASH DN01.

• DISPLAY SOFT EDIT IF SAMPLE_DP_ID = SAMPLE_PR_ID AND/OR SAMPLE_BL_ID.

WDS05000/(WIPE_INORG_DUP_SURF). WHAT TYPE OF SURFACE WAS WIPED WHEN COLLECTING THE WIPE-INORGANICS DUPLICATE SAMPLE?

Label	Code	Go To
SMOOTH SURFACE	1	WIPE_INORG_DUP_SURF_MAT
ROUGH SURFACE	2	WIPE_INORG_DUP_SURF_MAT
OTHER	-5

WDS06000/(WIPE_INORG_ DUP_SURF_OTH). SPECIFY: ____________________________________________

WDS07000/(WIPE_INORG_DUP_SURF_MAT). WHAT MATERIAL WAS THE SURFACE WIPED WHEN COLLECTING THE WIPE-INORGANICS DUPLICATE SAMPLE

Label	Code	Go To
VINYL	1	WIPE_INORG_DUP_ROOM_AREA
LINOLEUM	2	WIPE_INORG_DUP_ROOM_AREA
WOOD	3	WIPE_INORG_DUP_ROOM_AREA
CORK	4	WIPE_INORG_DUP_ROOM_AREA
RUBBER	5	WIPE_INORG_DUP_ROOM_AREA
CONCRETE	6	WIPE_INORG_DUP_ROOM_AREA
PAINTED	7	WIPE_INORG_DUP_ROOM_AREA
TILE	8	WIPE_INORG_DUP_ROOM_AREA
HIGH-PILE RUG/CARPET (GREATER THAN OR EQUAL TO ½ in)	9	WIPE_INORG_DUP_ROOM_AREA
LOW-PILE RUG/CARPET (LESS THAN ½ in)	10	WIPE_INORG_DUP_ROOM_AREA
OTHER	-5

WDS08000/(WIPE_INORG_DUP_SURF_MAT_OTH). SPECIFY: ____________________________________________

WDS09000/(WIPE_INORG_DUP_ROOM_AREA). WHERE IN THE ROOM WAS THE WIPE-INORGANICS DUPLICATE SAMPLE COLLECTED?

Label	Code	Go To
LESS THAN ONE FOOT FROM WALL	1
ONE FOOT OR MORE FROM WALL, BUT NOT LARGEST OPEN AREA	2

WDS10000/(WIPE_INORG_DUP_COMMENTS). RECORD ANY COMMENTS ABOUT THE WIPE-INORGANICS DUPLICATE SAMPLE COLLECTION:

 

COMMENTS: _____________________________________________________

(TIME_STAMP_WDS_ET).

PROGRAMMER INSTRUCTIONS

• INSERT DATE/TIME STAMP

• IF WIPE_INORG_COLLECT= 1 AND
  
  

• IF WIPE_INORG_SUBSAMPLES = 2, OR 1 AND 2, GO TO TIME_STAMP_WSS_ET.

• IF WIPE_INORG_SUBSAMPLES= 2 AND 3, OR 1, 2, AND 3, GO TO TIME_STAMP_WSS_ST.

WIPE-INORGANICS SPIKE SAMPLE

(TIME_STAMP_WSS_ST).

PROGRAMMER INSTRUCTIONS

• INSERT DATE/TIME STAMP

WSS01000/(WIPE_INORG_SPIKE_COLLECT). WAS THE WIPE-INORGANICS SPIKE SAMPLE INCLUDED?

Label	Code	Go To
YES	1
NO	2

PROGRAMMER INSTRUCTIONS

• IF WIPE_INORG_SPIKE_COLLECT= 1, SET SAMPLE_NUMBER ­= 4 AND GO TO SAMPLE_SP_ID.

• OTHERWISE, GO TO WIPE_INORG_SPIKE_NOTCOLL.

WSS02000/(WIPE_INORG_SPIKE_NOTCOLL). WHY WAS THE WIPE-INORGANICS SPIKE SAMPLE NOT INCLUDED?

Label	Code	Go To
SPIKE NOT AVAILABLE	1	WIPE_INORG_SPIKE_COMMENTS
OUT OF TIME	2	WIPE_INORG_SPIKE_COMMENTS
OTHER	-5

WSS03000/(WIPE_INORG_SPIKE_NOTCOLL_OTH). SPECIFY: ______________________________

PROGRAMMER INSTRUCTIONS

• GO TO WIPE_INORG_SPIKE_COMMENTS.

WSS04000/(SAMPLE_SP_ID). SPIKE SAMPLE ID:

|E||__|__|__|__|__|__|__|-DN01

 WIPE-INORGANICS SPIKE ID

DATA COLLECTOR INSTRUCTIONS

• ENTER THE WIPE-INORGANICSSPIKE SAMPLE ID ON THE SAMPLE ID LABEL.

PROGRAMMER INSTRUCTIONS

• ID MUST BE FORMATTED WITH TWO ALPHA 7 NUMERIC DASH DN01.

• DISPLAY SOFT EDIT IF SAMPLE_SP_ID = SAMPLE_PR_ID, SAMPLE_BL_ID AND/OR SAMPLE_DP_ID.

WSS05000/(WIPE_INORG_SPIKE_COMMENTS). RECORD ANY COMMENTS ABOUT THE WIPE-INORGANICS SPIKE SAMPLE COLLECTION:

 

COMMENTS: _____________________________________________________

(TIME_STAMP_WSS_ET).

PROGRAMMER INSTRUCTIONS

• INSERT DATE/TIME STAMP

Public reporting burden for this collection of information is estimated to average 1 minute per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0593*).  Do not return the completed form to this address.