Non-Infectious Drinking Water Issues CSTE

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⚠️ Notice: This information collection may be referencing outdated material.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
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

Information Collection (IC) Details

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:

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 %

	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

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.