Information Collection

Non-Infectious Drinking Water Issues CSTE

IC 219997 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 0920-16NK Non-Infectious Drinking Water Issues CSTE	Form and Instruction
0920-16NK Att A_CSTEDWA Instrument (Word Version) Att A_CSTEDWA Instrument (Word Version).docx	Form and Instruction
0920-16NK Att B_CSTEDWA Instrument (Web Version) Att B_CSTEDWA Instrument (Web Version).docx	Form and Instruction
Att C_CSTEDWA Invitation E-mail.docx Att C_CSTEDWA Invitation E-mail	IC Document
Att D_CSTEDWA Reminder E-mail.docx Att D_CSTEDWA Reminder E-mail	IC Document
CSTEDWA-SSA.docx CSTEDWA-SSA	IC Document
CSTEDWA-SSB.docx CSTEDWA-SSB	IC Document

IC Title:

Non-Infectious Drinking Water Issues CSTE

Agency IC Tracking Number:

16NK

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	0920-16NK	Att B_CSTEDWA Instrument (Web Version)	Att B_CSTEDWA Instrument (Web Version).docx		Yes	No	Fillable Printable
Form and Instruction	0920-16NK	Att A_CSTEDWA Instrument (Word Version)	Att A_CSTEDWA Instrument (Word Version).docx		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55

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	55	55
Annual IC Time Burden (Hours)	36	36
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att C_CSTEDWA Invitation E-mail	Att C_CSTEDWA Invitation E-mail.docx	02/04/2016
Att D_CSTEDWA Reminder E-mail	Att D_CSTEDWA Reminder E-mail.docx	02/04/2016
CSTEDWA-SSA	CSTEDWA-SSA.docx	02/04/2016
CSTEDWA-SSB	CSTEDWA-SSB.docx	02/04/2016

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