Information Collection Request

Mine Rescue Teams, Arrangements for Emergency Medical Assistance, and Arrangements for Transportation for Injured Persons

ICR 201508-1219-004 · OMB 1219-0078 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 5000-3 Mine Rescue Teams; Arrangements for Emergency Medical Assistance; and Arrangements for Transportation for Injured Persons Form and Instruction Modified Available
1219-0078 Supporting Statement 2016.doc Supporting Statement A Uploaded 2016-03-16 Available
1219-0078 PUBLISHED FRN 9-23-15 v80.pdf Supplementary Document Uploaded 2015-12-14 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
14446 Mine Rescue Teams; Arrangements for Emergency Medical Assistance; and Arrangements for Transportation for Injured Persons Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2019 12/31/2016 05/31/2016
20,041 0 20,043
10,109 0 10,111
309,067 0 309,067





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Mine Rescue Teams; Arrangements for Emergency Medical Assistance; and Arrangements for Transportation for Injured Persons 5000-3 Certificate of Physical Qualification for Mine Rescue Work

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 20,041 20,043 0 0 -2 0
Annual Time Burden (Hours) 10,109 10,111 0 0 -2 0
Annual Cost Burden (Dollars) 309,067 309,067 0 0 0 0


Reginfo record details
  No