Information Collection

PFAS Exposure Assessment Technical Tools Feedback

IC 227700 under ICR 201510-0923-001 · OMB 0923-0047.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
AttA DCHI PEATT Feedback Email.docx	Instruction
0923-0047 NCEH-ATSDR Srvc Dlvry Apprvl Frm PEATT Feedback v3 Trent signed.pdf Request for Approval	IC Document
AttB PFAS Exposure Assessment Technical Tools PEATT May 2017.pdf Technical Tools	IC Document
AttC PEATT Feedback RDF signed.pdf Non-research determination	IC Document

IC Title:

PFAS Exposure Assessment Technical Tools Feedback

Agency IC Tracking Number:

0923-0047-17AXS

IC Status: New

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
Instruction			AttA DCHI PEATT Feedback Email.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

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	40	40
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	0923-0047 NCEH-ATSDR Srvc Dlvry Apprvl Frm PEATT Feedback v3 Trent signed.pdf	07/25/2017
Technical Tools	AttB PFAS Exposure Assessment Technical Tools PEATT May 2017.pdf	07/25/2017
Non-research determination	AttC PEATT Feedback RDF signed.pdf	07/25/2017

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