Information Collection

Federally Unregulated Drinking Water Programs: Assessing Strategies Leading to Policy Change

IC 219903 under ICR 201412-0920-011 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Federally Unregulated Drinking Water Programs: Assessing Strategies Leading to Policy Change	Form and Instruction
Interview Guide Att B_Interview_Guide.docx	Form and Instruction
Att C_Invitation E-mail.docx Invitation E-mail	IC Document
Att D_Scheduling_In-person Interview.docx Scheduling In-Person Interview E-mail	IC Document
Att E_Confirmation_In-person Interview.docx Confirmation In-Person Interview E-mail	IC Document
Att F_Reminder E-mail.docx Reminder E-mail	IC Document
Att A_List_State_County_Health_Departments.docx List of the Participant State / County Health Departments	IC Document
PW-POLICY- SSA_02FEB2016.docx Supporting Statement A	IC Document
PW-POLICY-SSB_02FEB2016.docx Supporting Statement B	IC Document

IC Title:

Federally Unregulated Drinking Water Programs: Assessing Strategies Leading to Policy Change

Agency IC Tracking Number:

16MI

IC Status: New

Obligation to Respond: Voluntary

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	NA	Interview Guide	Att B_Interview_Guide.docx	NA	No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 18

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Invitation E-mail	Att C_Invitation E-mail.docx	01/29/2016
Scheduling In-Person Interview E-mail	Att D_Scheduling_In-person Interview.docx	01/29/2016
Confirmation In-Person Interview E-mail	Att E_Confirmation_In-person Interview.docx	01/29/2016
Reminder E-mail	Att F_Reminder E-mail.docx	01/29/2016
List of the Participant State / County Health Departments	Att A_List_State_County_Health_Departments.docx	01/29/2016
Supporting Statement A	PW-POLICY- SSA_02FEB2016.docx	02/02/2016
Supporting Statement B	PW-POLICY-SSB_02FEB2016.docx	02/02/2016

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