Information Collection

Respiratory Protection (29 CFR 1910.134)

IC 14015 under ICR 201511-1218-005 · OMB 1218-0099.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0099 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 29 CFR 1910.134 Respiratory Protection (29 CFR 1910.134)	Form
29 CFR 1910.134 Respirator Medical Evaluation Questionnaire 1910.134 OSHA Respirator Medical Evaluation Questionnaire (2).docx	Form
Appendix C Respirator medical Evaluation Questionnaire Adobe.pdf Appendix C Respirator Med. Questionnaire	IC Document

IC Title:

Respiratory Protection (29 CFR 1910.134)

Agency IC Tracking Number:

1218-0099(2014)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1910.134

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	29 CFR 1910.134	Respirator Medical Evaluation Questionnaire	1910.134 OSHA Respirator Medical Evaluation Questionnaire (2).docx		No		Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 616,035

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	23,443,707	0	2,004,711	21,438,996
Annual IC Time Burden (Hours)	6,971,401	-150,432	479,296	6,642,537
Annual IC Cost Burden (Dollars)	296,098,562	0	107,253,871	188,844,691

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix C Respirator Med. Questionnaire	Appendix C Respirator medical Evaluation Questionnaire Adobe.pdf	08/16/2016

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