Ingress/Egress and Work Boot Outsole Wear Investigation at Surface mines

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
IngressEgress_SupSta B.docx	Supporting Statement B	Uploaded 2016-05-26	Available
Appendix O.docx	Supplementary Document	Uploaded 2016-05-20	Available
Appendix N.docx	Supplementary Document	Uploaded 2016-05-20	Available
60-Day Published.pdf	Supplementary Document	Uploaded 2016-05-20	Available
Appendix A.docx	Supplementary Document	Uploaded 2016-05-20	Available
IngressEgress_SupSta A.docx	Supporting Statement A	Uploaded 2016-05-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
221627	App L_Informed Consent form (Longitudinal boot outsole study)	Other-WORD	New
221626	App J_Talent and Consent Waiver	Other-WORD	New
221624	App I_Final Survey for Boot Wear Evaluation	Other-WORD	New
221623	App H_Survey for Recording Period for Boot Wear Evaluation (On-going)	Other-WORD	New
221622	App G_Preliminary Survey for Boot Wear Evaluation	Other-WORD	New
221621	App F_Screening Questionnaire	Other-WORD	New
221618	App E_Mine management interview guide	Other-WORD	New
221617	App D_Mobile equipment operator interview guide	Other-WORD	New
221614	App C_Mobile equipment operator focus group guide	Other-WORD	New

ICR Details

OMB Control No: 0920-1125	ICR Reference No: 201605-0920-011
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 16GK
Title: Ingress/Egress and Work Boot Outsole Wear Investigation at Surface mines
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/22/2016
	Date Received in OIRA: 05/27/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2019	36 Months From Approved
Responses	3,100	0	0
Time Burden (Hours)	643	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Slips and falls of a person are the second largest contributor to non-fatal injuries in the U.S. mining industry. The objective of this work is to investigate how ingress egress systems on mobile equipment and personal protective footwear (boots) used by miners may lead to slips, trips and falls at stone, sand and gravel surface mining facilities.

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Authorizing Statute(s): PL: Pub.L. 95 - 164 2 Name of Law: Federal Mine Safety and Health Act of 1977
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 77349	12/14/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 32756	05/24/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
App C_Mobile equipment operator focus group guide
App L_Informed Consent form (Longitudinal boot outsole study)
App F_Screening Questionnaire
App E_Mine management interview guide
App G_Preliminary Survey for Boot Wear Evaluation
App I_Final Survey for Boot Wear Evaluation
App J_Talent and Consent Waiver
App H_Survey for Recording Period for Boot Wear Evaluation (On-going)
App D_Mobile equipment operator interview guide

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ICR Summary of Burden

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	3,100	0	0	3,100	0	0
Annual Time Burden (Hours)	643	0	0	643	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection request.

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Annual Cost to Federal Government: $411,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/27/2016

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