Information Collection

2019 254 of Q_EPA_Web_Browse_20190402_DL_December19 (004) (002)

IC 239313 under ICR 201805-1090-003 · OMB 1090-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 254 2019 254 of Q_EPA_Web_Browse_20190402_DL_December19 (004) (002)	Form and Instruction
254 Q_EPA_Web_Browse_20190402_DL_December19 (004) (002) 2019 254 of Q_EPA_Web_Browse_20190402_DL_December19 (004) (002).xlsx	Form and Instruction
OMB Feedback Survey Mapping File (version 1).xlsb.xlsx OMB Feedback Survey Mapping File (version 1).xlsb	IC Document
Signed OMB Clearence Form (EPA) 1_14_20.pdf Signed OMB Clearence Form (EPA) 1_14_20	IC Document

IC Title:

2019 254 of Q_EPA_Web_Browse_20190402_DL_December19 (004) (002)

Agency IC Tracking Number:

254

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	254	Q_EPA_Web_Browse_20190402_DL_December19 (004) (002)	2019 254 of Q_EPA_Web_Browse_20190402_DL_December19 (004) (002).xlsx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,600	3,600
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Feedback Survey Mapping File (version 1).xlsb	OMB Feedback Survey Mapping File (version 1).xlsb.xlsx	01/16/2020
Signed OMB Clearence Form (EPA) 1_14_20	Signed OMB Clearence Form (EPA) 1_14_20.pdf	01/16/2020

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