Information Collection

Asbestos in General Industry (29 CFR 1910.1001)

IC 14073 under ICR 201607-1218-013 · OMB 1218-0133.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0133 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 29 CFR 1910.1001 Asbestos in General Industry (29 CFR 1910.1001)	Form and Instruction
29 CFR 1910.1001 Appendix D Medical Questionnaires (Part 1 Initial Medica 1910.1001 Asbestos in Gen Ind App D Medical Questionnaires.docx	Form and Instruction
Asbestos in General Industry.pdf CFR Mark-up - Asbestos in General Industry Medical Questionnaires	IC Document

IC Title:

Asbestos in General Industry (29 CFR 1910.1001)

Agency IC Tracking Number:

1218-0133(2016)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1910.1001

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	29 CFR 1910.1001	Appendix D Medical Questionnaires (Part 1 Initial Medical Questionnaire; Part 2 Periodic Medical Questionnaire)	1910.1001 Asbestos in Gen Ind 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: 121

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	32,173	-80	32,253
Annual IC Time Burden (Hours)	11,688	-6	11,694
Annual IC Cost Burden (Dollars)	925,026	0	925,026

Documents for IC

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

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