Information Collection

State & Tribal Primacy Agencies

IC 45412 under ICR 201502-2040-001 · OMB 2040-0274.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 6100-02 State & Tribal Primacy Agencies	Form and Instruction
6100-02 2015 Drinking Water Infrastructure Needs Survey and Asse EPA Form 6100-02.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	6100-02	2015 Drinking Water Infrastructure Needs Survey and Assessment	EPA Form 6100-02.pdf		Yes	Yes	Fillable Printable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

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)	7,124	7,124
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.