Eligibility Screening - Adult/Adolescent Field Users

Characterization of Exposure Potential during Activities Conducted on Synthetic Turf with Crumb Rubber Infill

OMB: 0923-0058

IC ID: 226774

Information Collection (IC) Details

View Information Collection (IC)

Eligibility Screening - Adult/Adolescent Field Users
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Field User Eligibility Screening Script Att4b Field User Eligibility Screening Script_Final.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

Record of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances  76 FR 4432

41 0
   
Individuals or Households
 
   100 %

  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 41 0 41 0 0 0
Annual IC Time Burden (Hours) 3 0 3 0 0 0
Annual IC Cost Burden (Dollars) 25 0 25 0 0 0

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

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