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Application for Reimbursement to Local Governments for Emergency Response to Hazardous Substance Releases Under CERCLA section 123 (Renewal)
Application for Reimbursement to Local Governments for Emergency Response to Hazardous Substance Releases Under CERCLA section 123 (Renewal)
OMB: 2050-0077
IC ID: 23856
OMB.report
EPA/OLEM
OMB 2050-0077
ICR 201412-2050-003
IC 23856
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2050-0077 can be found here:
2023-09-07 - Reinstatement with change of a previously approved collection
2022-03-25 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 9310-1
Application for Reimbursement to Local Governments for Emergency Response to Hazardous Substance Releases Under CERCLA section 123 (Renewal)
Form and Instruction
9310-1 Application Package for Reimbursement to Local Governmen
1425.10 Form 9310-1.pdf
www2.epa.gov/sites/production/files/documents/application_package_for_local_government_reimbursement.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Reimbursement to Local Governments for Emergency Response to Hazardous Substance Releases Under CERCLA section 123 (Renewal)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
40 CFR 310.10-310.12
40 CFR 310.05
40 CFR 310.2-310.9
40 CFR Part 310, appendix II (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
9310-1
Application Package for Reimbursement to Local Governments
1425.10 Form 9310-1.pdf
http://www2.epa.gov/sites/production/files/documents/application_package_for_local_government_reimbursement.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Environmental Management
Subfunction:
Environmental Monitoring and Forecasting
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
30
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
30
0
0
-30
0
60
Annual IC Time Burden (Hours)
270
0
0
-270
0
540
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.