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

Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.