Information Collection

780.21 - What requirements apply to preparation and review of the cumulative hydrologic impact assessment (CHIA)? (Industry)

IC 213804 under ICR 201411-1029-004 · OMB 1029-0133.

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IC Title:	780.21 - What requirements apply to preparation and review of the cumulative hydrologic impact assessment (CHIA)? (Industry)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 780.21

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 125	Number of Respondents for Small Entity: 123

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 75 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	125	125
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	25,000	25,000

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