Employer documentation of refusal to provide blood, breath urine specimens for chemical test

Report of Marine Casualty & Chemical Testing of Commercial Vessel Personnel

OMB: 1625-0001

IC ID: 185219

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Employer documentation of refusal to provide blood, breath urine specimens for chemical test
 
No Unchanged
 
Mandatory
 
46 CFR 4.06

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction 1625-0001_Inst_r5_2016-inv.doc Yes Yes Printable Only

Transportation Water Transportation

 

1 0
   
Private Sector Businesses or other for-profits
 
   40 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1 0 0 0 0 1
Annual IC Time Burden (Hours) 1 0 0 0 0 1
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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