Information Collection

Assessing and Evaluating the Effectiveness of Hazard Recognition and Risk Assessment Interventions

IC 231621 under ICR 201505-0920-003 · OMB 0920-0953.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0953 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att A_EXAMiner_Evaluation_Trainee.061518.docx	Other-WORD
Att B_EXAMiner_Interview_Mine Safety and Health Professional.061518.docx	Other-WORD
Att C_AreYouThinkingLikeanEXAMiner_Interviews.docx	Other-WORD
Att C1_AreYouThinkingLikeanEXAMiner_Evaluation_Interview.docx	Other-WORD
Att C2_AreYouThinkingLikeanEXAMiner_JobAid_Interview.061518.docx	Other-WORD
Att D- Pre Job Aid.docx	Other-WORD
Att D1_AreYouThinkingLikeanEXAMiner_Job Aid.061518.docx	Other-WORD
Att D2- Post Job Aid.docx	Other-WORD
GenICRequest2.061518.docx Request for Approval	IC Document

IC Title:

Assessing and Evaluating the Effectiveness of Hazard Recognition and Risk Assessment Interventions

Agency IC Tracking Number:

0920-0953 (18AJZ)

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-WORD	Att A_EXAMiner_Evaluation_Trainee.061518.docx	No	Fillable Fileable
Other-WORD	Att B_EXAMiner_Interview_Mine Safety and Health Professional.061518.docx	No	Fillable Fileable
Other-WORD	Att C_AreYouThinkingLikeanEXAMiner_Interviews.docx	No	Fillable Fileable
Other-WORD	Att C1_AreYouThinkingLikeanEXAMiner_Evaluation_Interview.docx	No	Fillable Fileable
Other-WORD	Att C2_AreYouThinkingLikeanEXAMiner_JobAid_Interview.061518.docx	No	Fillable Fileable
Other-WORD	Att D- Pre Job Aid.docx	No	Fillable Fileable
Other-WORD	Att D1_AreYouThinkingLikeanEXAMiner_Job Aid.061518.docx	No	Fillable Fileable
Other-WORD	Att D2- Post Job Aid.docx	No	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 670

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	670	670
Annual IC Time Burden (Hours)	247	247
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	GenICRequest2.061518.docx	06/15/2018

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