Youth Exposure Measurement

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

Documents and Forms

Document Name Document Type
Youth Exposure Measurement Form
Youth Exposure Measurement Att4f Exposure Measurement Form_Final clean.docx Form

Information Collection (IC) Details

IC Title:	Youth Exposure Measurement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Youth Exposure Measurement	Att4f Exposure Measurement Form_Final clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Record of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances	FR Citation: 76 FR 4432

Number of Respondents: 18	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	54	54
Annual IC Cost Burden (Dollars)	1,254	1,254

Documents for IC

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.