Undetermined Source of an outbreak of Legionnaires' Disease among Hotel A Visitors - Hannibal, MO 2015

Emergency Epidemic Investigation Data Collections - Expedited Reviews

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1011 can be found here:

Documents and Forms

Document Name Document Type
Undetermined Source of an outbreak of Legionnaires' Disease among Hotel A Visitors - Hannibal, MO 2015 Form and Instruction
Legionella Environmental Assessment Form Appendix 1 w coverpage.pdf Form and Instruction
Sample Data Sheet Appendix 2 w coverpage.pdf Form
2016004-XXX LD_MO.docx GenIC Request Legionalla_MO 2015 IC Document
GenIC Burden Hour Memo Email Legionella_MO 2015.msg Burden Memo Email Legionella_MO 2015 IC Document
MissouriEpiAid_2015 Formal Invitation Letter.docx Letter of Invitation Legionella_MO 2015 IC Document

Information Collection (IC) Details

IC Title:	Undetermined Source of an outbreak of Legionnaires' Disease among Hotel A Visitors - Hannibal, MO 2015	Agency IC Tracking Number:	0920-1011

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Legionella Environmental Assessment Form	Appendix 1 w coverpage.pdf	NA	No		Paper Only
Form	NA	Sample Data Sheet	Appendix 2 w coverpage.pdf	NA	No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: Epidemic Investigation Case Records - 09-20-0113	FR Citation: 51 FR 42466

Number of Respondents: 12	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request Legionalla_MO 2015	2016004-XXX LD_MO.docx	11/07/2015
Burden Memo Email Legionella_MO 2015	GenIC Burden Hour Memo Email Legionella_MO 2015.msg	11/07/2015
Letter of Invitation Legionella_MO 2015	MissouriEpiAid_2015 Formal Invitation Letter.docx	11/07/2015

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