EIA-851Q Domestic Uranium Production Report (Quarterly)

CIPSEA Confidentiality Pledge Revision

Form EIA-851Q (rev2017 CIPSEA).xls

Uranium Data Collection (OMB 1905-0160)

OMB: 1905-0211

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U.S. Department of Energy OMB No. 1905-0160
U.S. Energy Information Administration Form Reclearance
Washington, DC 20585 Approval Expires: XX/XX/XXXX
Form EIA-851Q Burden: 0.75 hours
Domestic Uranium Production Report (Quarterly)
4th Quarter 2015
This report is mandatory under the Federal Energy Administration Act of 1974 (Public Law 93-275). Failure to comply may result in criminal fines, civil penalties and other sanctions as provided by law. For further information concerning sanctions and data protections see the provision on sanctions and the provision concerning the confidentiality of information in the instructions. Title 18 USC 1001 makes it a criminal offense for any person knowingly and willingly to make to any Agency or Department of the United States any false, fictitious, or fraudulent statements as to any matter within its jurisdiction. REPORTING BURDEN: Public reporting burden for this collection of information is estimated to average 0.75 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Energy Information Administration, Survey Development and Statistical Integration, EI-21, Forrestal Building, 1000 Independence Avenue S.W., Washington, D.C. 20585-0670; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, D.C. 20503. A person is not required to respond to the collection of information unless the form displays a valid OMB number.
RESPONDENT AND CONTACT IDENTIFICATION
Company Name:
Preparer Name:
Company Address:
Preparer Title:
Company City:
Preparer Company Name:
Company State:
Preparer Address:
Company Zip Code:
Preparer City:


Preparer State:
Parent Company Name:
Preparer Zip Code:
Parent Company Street Address:
Preparer Phone #:
Parent Company City:
Preparer Fax #:
Parent Company State:
Preparer E-mail Address:
Parent Company Zip Code:




Supervisor Name:


Supervisor Title:


Supervisor Company Name:


Supervisor Address:


Supervisor City:


Supervisor State:


Supervisor Zip Code:


Supervisor Phone #:


Supervisor Fax #:


Supervisor E-mail Address:




ITEM 1: FACILITY INFORMATION
CONFIDENTIALITY OF INFORMATION: The items RESPONDENT IDENTIFICATION Company Name and all of ITEM 1: FACILITY INFORMATION on Form EIA-851Q are NOT considered confidential and may be publicly released in identifiable form.
Name:
County:
State:
Owner:
Type:
Rated Capacity:
Operating Status:


ITEM 2: PRODUCTION Pounds U3O8 All other information you provide in Items 2 and 3 on Form EIA-851Q will be used for statistical purposes only and is confidential by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002 and other applicable Federal laws, your responses will not be disclosed in identifiable form without your consent. Per the Federal Cybersecurity Enhancement Act of 2015, Federal information systems are protected from malicious activities through cybersecurity screening of transmitted data. Every EIA employee, as well as every agent, is subject to a jail term, a fine, or both if he or she makes public ANY identifiable information you reported.
October-2015
November-2015
December-2015
Total = 0.0


ITEM 3: PRODUCTION SOURCE
Mine name(s) Pounds U3O8










Other type: Pounds U3O8




Total = 0.0
COMMENTS





File Typeapplication/vnd.ms-excel
File TitleForm EIA-851Q
SubjectDomestic Uranium Production Report (Quarterly)
AuthorDouglas Bonnar
Last Modified ByMurray, Patrick
File Modified2017-03-30
File Created2003-11-12

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