Information Collection

Asbestos in Shipyards (29 CFR 1915.1001)

IC 14151 under ICR 201607-1218-012 · OMB 1218-0195.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0195 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1915.1001 Appendix Asbestos in Shipyards (29 CFR 1915.1001)	Form and Instruction
1915.1001 Appendix Medical Questionnaires 1915.1001 Asbestos in Shipyards - App D Medical Questionnaires.docx	Form and Instruction
Asbestos in Shipyards.pdf CFR Mark-up - Asbestos in Shipyards Appendix D Medical Questionnaires	IC Document

IC Title:

Asbestos in Shipyards (29 CFR 1915.1001)

Agency IC Tracking Number:

1218-0195(2016)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1915.1001

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 and Instruction	1915.1001 Appendix D	Medical Questionnaires	1915.1001 Asbestos in Shipyards - App D Medical Questionnaires.docx		Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 317

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	Previously Approved
Annual Number of Responses for this IC	3,072	3,072
Annual IC Time Burden (Hours)	1,189	1,189
Annual IC Cost Burden (Dollars)	43,003	43,003

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CFR Mark-up - Asbestos in Shipyards Appendix D Medical Questionnaires	Asbestos in Shipyards.pdf	08/08/2016

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