Instructions for use of Generic Clearance 30MAR2017

Attachment C

Instructions for Using the Generic Information Collection Request (ICR)

Review the scope of the “Assessment of Potential Exposure from Private Wells for Drinking Water” Information Collection Request (ICR) (OMB No. 0920-xxxx).

1. E-mail the following to the NCEH/ATSDR Information Collection Request Liaison (ICRL):

   1. Letter of invitation/collaboration from the local, tribal, or state health authority

   2. A completed “Request For Approval Under Generic ICR” form

   3. A complete Supporting Statement A justifying the collection and a Supporting Statement B describing the proposed sampling plan and statistical methods for the GenIC.

2. The ICRL will review the request and determine whether it meets the criteria for the scope of the “Assessment of Potential Exposure from Private Wells for Drinking Water” ICR.

3. If the proposed investigation is deemed appropriate for this clearance, the ICRL will notify the NCEH program to complete the GenIC package, including data collection instruments.

4. The NCEH program will submit the GenIC package to the ICRL via email or via S3P, as appropriate.

5. The ICRL will submit the request to the CDC Information Collection Review Office (ICRO) for PRA clearance.

6. Data collection cannot begin until OMB has approved the information.

7. Upon receiving OMB approval, data collection may proceed.

8. On the cover or first page of each data collection instrument, include the OMB Control Number and expiration date (0920-xxxx; expiration date mm/dd/yyyy) in the upper right corner and the public reporting burden statement in the footer.

9. Prior to data collection, investigators must inform respondents that participation is voluntary, that respondents will not be personally identified in any published reports of the study, and that their privacy will be protected to the extent allowed under federal law.

Questions or Comments? Contact the Information Collection Request Liaison (ICRL):

Stephanie I. Davis, MSPH

OMB-PRA Contact

NCEH/ATSDR Office of Science

Office: 770-488-3676

BlackBerry: 404-213-2967

[email protected]