Information Collection

Camp Lejeune Drinking Water Notification Registry

IC 185160 under ICR 201610-0703-002 · OMB 0703-0057.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0703-0057 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Website screenshot with dropdown.pdf www.marines.mil/clwater	Other-Website Screenshots
PAS and ADN screenshot.PDF	Other-Screenshot

IC Title:

Camp Lejeune Drinking Water Notification Registry

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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
Other-Website Screenshots			Website screenshot with dropdown.pdf	http://www.marines.mil/clwater	Yes	Yes	Fillable Fileable
Other-Screenshot			PAS and ADN screenshot.PDF		No		Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: MCB Camp Lejeune Historic Drinking Water Notification Registry

FR Citation: 80 FR 15196

Number of Respondents: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 85 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	10,000	8,400	1,600
Annual IC Time Burden (Hours)	1,000	830	170
Annual IC Cost Burden (Dollars)	23,230	23,230	0

Documents for IC

table that charts IC Documents
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.