FY16 (Q4) California Drought -- Mariposa County, 2016

0920-1036 Change Request Justification 2016 Q4.docx

California Drought - Mariposa County, 2016 (Quarter 4)

FY16 (Q4) California Drought -- Mariposa County, 2016

OMB: 0920-1036

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SUBMISSION DATE: 20170914

NCEH GENERIC CLEARANCE FOR “COMMUNITY ASSESSMENT FOR PUBLIC HEALTH EMERGENCY RESPONSE (CASPER)”

OMB CONTROL NO. 0920-1036 (EXP. DATE 12/31/2017)


QUARTERLY CHANGE REQUEST

JUSTIFICATION: This is a change request to report the actual burden hours used for CASPER GenICs.

REPORTING PERIOD

FISCAL YEAR: 2016

QUARTER: 4


SUMMARY OF APPROVED NUMBER OF RESPONSES AND BURDEN HOURS


APPROVED DATES

DATE OF COLLECTION

RESPONSES

BURDEN HOURS

GENERIC CLEARANCE

Exp Date

12/31/2017


9600

4731

BALANCE REMAINING



9007

4439

GenIC REPORT

Community Assessment for Public Health Emergency Response (CASPER) addressing the California Drought – Mariposa County, 2016

10/11/2016

04/09/2017

10/25/2016 10/27/2016

189

94.50

(5670/60 minutes)

3

0.25

(15/60 minutes)

GenIC Attachments:

Mariposa County CA 2016 CASPER Questionnaire - final

Mariposa County CA 2016 CASPER Referral Form - final



Attachment H. Burden Memo - final



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