Pavement Preservation Research Roadmap

Pavement Preservation Research Roadmap Fast Track Form.docx

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

Pavement Preservation Research Roadmap

OMB: 2125-0628

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 2125-0628)

Shape1 TITLE OF INFORMATION COLLECTION: Update of the Pavement Preservation Research Roadmap


PURPOSE: To prioritize the research needs statements that have been developed from 7 go-to meetings. Having national consensus on relative priorities will encourage state agencies and others funding pavement preservation research to focus on high priority items, resulting in the most effective use of research funding.









DESCRIPTION OF RESPONDENTS: representatives of state agencies from attendees at Pavement Preservation Partnership meetings, Pavement Preservation Expert Task Group, Emulsion Task Force, TRB Committee AHD18 (Pavement Preservation), FHWA personnel in pavement preservation activities, representatives of ARRA, AEMA and ISSA (industry groups in pavement preservation area), consultants working in pavement preservation area







TYPE OF COLLECTION: (Check one)


[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ X] Other: Surveys asking for priorities for specific research needs statements______________________


CERTIFICATION:


I certify the following to be true:

  1. The collection is voluntary.

  2. The collection is low-burden for respondents and low-cost for the Federal Government.

  3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

  4. The results are not intended to be disseminated to the public.

  5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

  6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.


Name:___Antonio Nieves Torres__________________________________


To assist review, please provide answers to the following question:


Personally Identifiable Information:

  1. Is personally identifiable information (PII) collected? [ ] Yes [ x] No

  2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ x ] No

  3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ x ] No


Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ x ] No





BURDEN HOURS


Category of Respondent

No. of Respondents

Participation Time

Burden

State DOT

50

10min

8.33

Academia

25

10min

4.2

Industry Associations

25

10min

4.2

Totals

100


16.72


FEDERAL COST: The estimated annual cost to the Federal government is This work is being conducted by a contractor for FHWA. This will be done only once. Estimated cost aprox. $1,200.____________


If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:


The selection of your targeted respondents

  1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ x] Yes [ ] No


If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?


State DOT, Academia, Industry Association










Administration of the Instrument

  1. How will you collect the information? (Check all that apply)

[ x ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

  1. Will interviewers or facilitators be used? [ ] Yes [ x] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.


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