Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Renewal)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 5800-050 Viburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey	Form	New	Repair queued
Form 5800-048 e-Manifest Electronic Manifest Questionnaire	Form	New	Repair queued
Form 5800-049 Site User Satisfaction Survey	Form	New	Repair queued
ECHO Post Training Survey Questions	Form and Instruction	New	Repair queued
Form 6200-021 AR 2020 Post Event Survey	Form and Instruction	New	Repair queued
Form 5800-013 Los Angeles Public Library Patron Air Sensor Loan Survey	Form and Instruction	New	Repair queued
EPA Tools & Resources Webinar Series & EPA Science Training Webinars -- Evaluation Form	Form and Instruction	New	Repair queued
Form 7100-002 Survey of Certification Plan and Reporting Database Users – Evaluating User Access	Form and Instruction	New	Available
Form 5800-011 Science Matters Survey	Form and Instruction	New	Available
Form 5800-0012 Customer Satisfaction Survey	Form and Instruction	New	Available
Form 6200-020 Virtual vs In Person America Recycles 2020 Events Survey	Form and Instruction	New	Available
Form 5800-010 NeT Zendesk Customer Survey	Form and Instruction	New	Available
Form 5800-009 ECMPS Survey	Form	New	Available
Form 5800-008 Lead Librarian Training Evaluation	Form and Instruction	New	Available
Form 5800-007 EnviroAtlas Training and Resources Customer Service Survey	Form	New	Available
Form 5800-006 ORD State Engagement Feedback Survey	Form	New	Available
Form 6200-020 Customer Satisfaction Survey for the America Recycles Events	Form and Instruction	New	Available
Form 7100-001 Focus Group Work Sheet	Form	New	Available
Form 6100-055 Training Workshop Evaluation - Exploring and Applying Surface Water Modeling Tools to Achieve Program Goals	Form and Instruction	New	Available
Script for State and Tribal QAPP Training and Resource Needs Survey	Form and Instruction	New	Available
Form 5800-003 Customer Service Survey	Form and Instruction	New	Available
Instrument for Stormwater Action Plan - script	Form and Instruction	New	Available
TRI Website Survey	Form and Instruction	New	Available
Follow-up Questionnaire: Forum on SMM in the Built Environment	Form and Instruction	New	Available
Form 6700-007 Evaluation: EPA Region 5 Advanced Worker Protection Standard Inspector Training	Form and Instruction	New	Available
Form - System Usability Scale	Form and Instruction	New	Available
Sample Focus Group 2434ss72 PSA Surveys-Focus Group Studies.docx	Supplementary Document	Uploaded 2018-03-13	Available
Sample Focus Group 2434ss72 PSA Surveys-HCNScript1.pdf	Supplementary Document	Uploaded 2018-03-13	Available
2434ss75B revOMB.docx	Supporting Statement B	Uploaded 2018-03-13	Available
2434ss75A revOMB.docx	Supporting Statement A	Uploaded 2018-03-13	Available
Template Generic Clearance Submission.docx	Supplementary Document	Uploaded 2014-11-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
246386	Viburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey	Form	New	Viburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey
246260	e-Manifest Electronic Manifest Questionnaire	Form	New	e-Manifest Electronic Manifest Questionnaire
246210	Great Lakes AOC Project Area Community Use and Benefits Site User Satisfaction Survey	Form	New	Site User Satisfaction Survey
246026	ECHO Post Training Survey Questions	Form and Instruction	New	ECHO Post Training Survey Questions
245084	Customer Satisfaction Survey for the America Recycles Events	Form and Instruction	New	AR 2020 Post Event Survey
244954	Evaluating the Pilot Los Angeles Public Library Sensor Loan Program: Patron Air Sensor Use Component	Form and Instruction	New	Los Angeles Public Library Patron Air Sensor Loan Survey
244830	Office of Research & Development's EPA Tools & Resources Webinar Series and EPA Science Training Webinars attendee satisfaction survey.	Form and Instruction	New	EPA Tools & Resources Webinar Series & EPA Science Training Webinars -- Evaluation Form
244181	Guest Speaker Survey	Other-Request for Generic IC Approval	New
243538	Survey of Certification Plan and Reporting Database Users – Evaluating User Access	Form and Instruction	New	Survey of Certification Plan and Reporting Database Users – Evaluating User Access
243077	Office of Research and Development Science Matters Newsletter Customer Satisfaction Survey	Form and Instruction	New	Science Matters Survey
242891	Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10	Form and Instruction	New	Customer Satisfaction Survey
242671	Customer Satisfaction Survey for Format of 2020 America Recycles Events	Form and Instruction	New	Virtual vs In Person America Recycles 2020 Events Survey
242480	Helpdesk Customer Satisfaction Survey for the Integrated Compliance Information System (ICIS) and the National Pollutant Discharge Elimination System (NPDES) eReporting Tools (NeT, NeTDMR)	Form and Instruction	New	NeT Zendesk Customer Survey
242334	Fish Consumption Advisories	Other-Discussion Guide	New
242224	Focus Groups with Farmworkers - Evaluating videos and posters	Other-Moderator Guide	New
242205	ECMPS Client Tool Usage Survey	Form	New	ECMPS Survey
241979	Evaluating the Pilot Los Angeles Public Library Sensor Loan Program: Lead Librarian Training Component	Form and Instruction	New	Lead Librarian Training Evaluation
241707	EnviroAtlas Training and Resources Customer Satisfaction Survey	Form	New	EnviroAtlas Training and Resources Customer Service Survey
241654	Customer Satisfaction Survey for state government officials that participated in the Office of Research and Development's FY 2019-2022 strategic research planning and implementation process	Form	New	ORD State Engagement Feedback Survey
241194	Focus Group with Farmworkers - Evaluating Draft Radio Scripts	Other-Focus Group Moderator Guide	New
240970	Customer Satisfaction Survey for the America Recycles Events	Form and Instruction	New	Customer Satisfaction Survey for the America Recycles Events
240862	Industry Beta-Testing of Chemical Data Reporting (CDR) Electronic Reporting Tool	Other-Beta Testing Slides	New
238629	Focus Groups with Farmworkers- Evaluating Draft Worker Safety Posters and Icons	Form	New	Focus Group Work Sheet
238041	Exploring and Applying Surface Water Modeling Tools to Achieve Program Goals Training Workshop Evaluation	Form and Instruction	New	Training Workshop Evaluation - Exploring and Applying Surface Water Modeling Tools to Achieve Program Goals
237610	Quality Assurance Project Plan Initiative Survey: Training and Resource Needs	Form and Instruction	New	Script for State and Tribal QAPP Training and Resource Needs Survey
237508	EPA Docket Center Customer Satisfaction Survey	Form and Instruction	New	Customer Service Survey
237484	Stormwater Technical Assistance Process Evaluation	Form and Instruction	New	Instrument for Stormwater Action Plan - script
235659	Decision Integration for Strong Communities Application Customer Satisfaction Survey	Other-Script	New
234888	Structured Interviews with 22 Grantees on Grant Program Structure	Other-Interview Questions	New
234122	Usability and Functionality Survey of How's My Waterway 2.0 at the 2018 Restore America's Estuaries Summit	Other-Script	New
232959	Toxics Release Inventory (TRI) Program Website Customer Satisfaction Survey	Form and Instruction	New	TRI Website Survey
232905	Forum on Life Cycle Approaches to Sustainably Manage Materials in Building and Infrastructure Projects Outcomes Prioritization Survey	Form and Instruction	New	Follow-up Questionnaire: Forum on SMM in the Built Environment
231426	Post-Webinar Survey of Trainees Monitoring the EPA Region 5 Advanced Worker Protection Standard Inspector Training	Form and Instruction	New	Evaluation: EPA Region 5 Advanced Worker Protection Standard Inspector Training
231096	eManifest User Testing	Form and Instruction	New	System Usability Scale
231096	eManifest User Testing	Other-Testing Notes and Task Scores	New
230981	EHD Survey	Other-Survey	New
229285	Small Systems Survey	Other-	New
229284	CTS Survey	Other-	New
229283	Healthier Survey	Other-	New
229282	ICIS Survey	Other-	New
229281	OPP Focus Group	Other-	New
229280	EJScreen Useful Survey	Other-	New
229279	CDX IT System Survey	Other-	New
229277	R2 Children's Health Survey	Other-	New
229276	Toxics Release Inventory Webinar Survey	Other-	New
229275	Climate Adaption Resource Center Website Survey	Other-	New
229274	Alternate Dispute Survey	Other-	New
229273	OSA Survey	Other-	New
229272	ECCR Survey	Other-	New
229271	OSC Technical Assistance Survey	Other-	New
229270	EJScreen	Other-	New
229269	RCRA First Survey	Other-	New
229268	eSIP CDX Survey	Other-	New
229267	P2RIC Survey	Other-	New
229266	Solar Survey	Other-	New
229265	WPS Poster Survey	Other-	New
229264	Cincinnati Focus Group	Other-	New
229263	CRW Website Survey Revised	Other-	New
229262	CRW Website Survey	Other-	New
229261	PSA Surveys	Other-	New
229260	TRI-ME2 Survey	Other-	New
229259	CDX Support Surveys	Other-	New
229258	OSA Survey	Other-	New
229257	WQSA Survey	Other-	New
229256	Envirofacts	Other-	New
229255	iSHC Survey	Other-	New
229254	LFLP Survey	Other-	New
229253	eGrid Survey	Other-	New
229252	WPS Focus Group	Other-	New
229251	R9 Training Survey	Other-	New
229250	WEFTEC Survey	Other-	New
229249	Air Sensor Survey	Other-	New
229248	Pesticide Survey	Other-	New
229247	TRI Website	Other-	New
229246	Acquisition 360 Survey	Other-	New
229245	Tanks Conference	Other-	New
229243	ESML Survey	Other-	New
229242	RSEI Survey	Other-	New
229241	CDX Help Desk Survey	Other-	New
229240	CDX Customer Satisfaction Survey	Other-	New

ICR Details

OMB Control No: 2010-0042	ICR Reference No: 201711-2010-001
Status: Historical Active	Previous ICR Reference No: 201604-2010-001
Agency/Subagency: EPA/OP	Agency Tracking No: 2434.75
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Renewal)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/13/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/30/2017
Terms of Clearance: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.”

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2021	36 Months From Approved	03/31/2018
Responses	120,000	0	120,000
Time Burden (Hours)	30,000	0	20,000
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 33908	09/19/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 55362	11/21/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 79

table that charts list of burden

IC Title	Form No.	Form Name
OSA Survey
RCRA First Survey
TRI-ME2 Survey
Acquisition 360 Survey
Air Sensor Survey
Alternate Dispute Survey
CDX Customer Satisfaction Survey
CDX Help Desk Survey
CDX IT System Survey
CDX Support Surveys
CRW Website Survey
CRW Website Survey Revised
CTS Survey
Cincinnati Focus Group
Climate Adaption Resource Center Website Survey
Customer Satisfaction Survey for Format of 2020 America Recycles Events	6200-020	Virtual vs In Person America Recycles 2020 Events Survey
Customer Satisfaction Survey for state government officials that participated in the Office of Research and Development's FY 2019-2022 strategic research planning and implementation process	5800-006	ORD State Engagement Feedback Survey
Customer Satisfaction Survey for the America Recycles Events	6200-020	Customer Satisfaction Survey for the America Recycles Events
Customer Satisfaction Survey for the America Recycles Events	6200-021	AR 2020 Post Event Survey
Decision Integration for Strong Communities Application Customer Satisfaction Survey
ECCR Survey
ECHO Post Training Survey Questions	NA	ECHO Post Training Survey Questions
ECMPS Client Tool Usage Survey	5800-009	ECMPS Survey
EHD Survey
EJScreen
EJScreen Useful Survey
EPA Docket Center Customer Satisfaction Survey	5800-003	Customer Service Survey
ESML Survey
EnviroAtlas Training and Resources Customer Satisfaction Survey	5800-007	EnviroAtlas Training and Resources Customer Service Survey
Envirofacts
Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10	5800-0012	Customer Satisfaction Survey
Evaluating the Pilot Los Angeles Public Library Sensor Loan Program: Lead Librarian Training Component	5800-008	Lead Librarian Training Evaluation
Evaluating the Pilot Los Angeles Public Library Sensor Loan Program: Patron Air Sensor Use Component	5800-013	Los Angeles Public Library Patron Air Sensor Loan Survey
Exploring and Applying Surface Water Modeling Tools to Achieve Program Goals Training Workshop Evaluation	6100-055	Training Workshop Evaluation - Exploring and Applying Surface Water Modeling Tools to Achieve Program Goals
Fish Consumption Advisories
Focus Group with Farmworkers - Evaluating Draft Radio Scripts
Focus Groups with Farmworkers - Evaluating videos and posters
Focus Groups with Farmworkers- Evaluating Draft Worker Safety Posters and Icons	7100-001	Focus Group Work Sheet
Forum on Life Cycle Approaches to Sustainably Manage Materials in Building and Infrastructure Projects Outcomes Prioritization Survey	n/a	Follow-up Questionnaire: Forum on SMM in the Built Environment
Great Lakes AOC Project Area Community Use and Benefits Site User Satisfaction Survey	5800-049	Site User Satisfaction Survey
Guest Speaker Survey
Healthier Survey
Helpdesk Customer Satisfaction Survey for the Integrated Compliance Information System (ICIS) and the National Pollutant Discharge Elimination System (NPDES) eReporting Tools (NeT, NeTDMR)	5800-010	NeT Zendesk Customer Survey
ICIS Survey
Industry Beta-Testing of Chemical Data Reporting (CDR) Electronic Reporting Tool
LFLP Survey
OPP Focus Group
OSA Survey
OSC Technical Assistance Survey
Office of Research & Development's EPA Tools & Resources Webinar Series and EPA Science Training Webinars attendee satisfaction survey.	NA	EPA Tools & Resources Webinar Series & EPA Science Training Webinars -- Evaluation Form
Office of Research and Development Science Matters Newsletter Customer Satisfaction Survey	5800-011	Science Matters Survey
P2RIC Survey
PSA Surveys
Pesticide Survey
Post-Webinar Survey of Trainees Monitoring the EPA Region 5 Advanced Worker Protection Standard Inspector Training	6700-007	Evaluation: EPA Region 5 Advanced Worker Protection Standard Inspector Training
Quality Assurance Project Plan Initiative Survey: Training and Resource Needs	n/a	Script for State and Tribal QAPP Training and Resource Needs Survey
R2 Children's Health Survey
R9 Training Survey
RSEI Survey
Small Systems Survey
Solar Survey
Stormwater Technical Assistance Process Evaluation	n/a	Instrument for Stormwater Action Plan - script
Structured Interviews with 22 Grantees on Grant Program Structure
Survey of Certification Plan and Reporting Database Users – Evaluating User Access	7100-002	Survey of Certification Plan and Reporting Database Users – Evaluating User Access
TRI Website
Tanks Conference
Toxics Release Inventory (TRI) Program Website Customer Satisfaction Survey	n/a	TRI Website Survey
Toxics Release Inventory Webinar Survey
Usability and Functionality Survey of How's My Waterway 2.0 at the 2018 Restore America's Estuaries Summit
Viburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey	5800-050	Viburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey
WEFTEC Survey
WPS Focus Group
WPS Poster Survey
WQSA Survey
e-Manifest Electronic Manifest Questionnaire	5800-048	e-Manifest Electronic Manifest Questionnaire
eGrid Survey
eManifest User Testing	-	System Usability Scale
eSIP CDX Survey
iSHC Survey

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	120,000	120,000	0	0	0	0
Annual Time Burden (Hours)	30,000	20,000	0	0	10,000	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden hour has increased by 10,000, which reflects the increased use of the generic clearance that we have seen over the past few years.

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Annual Cost to Federal Government: $18,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/30/2017

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