Environmental Public Health Tracking Work Plan Template

Environmental Public Health Tracking Network (Tracking Network)

OMB: 0920-1175

IC ID: 222650

Information Collection (IC) Details

View Information Collection (IC)

Environmental Public Health Tracking Work Plan Template
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Program Management Tool (New Awardees) Form Att5a_ProgramManagmentTool_Form.doc NA Yes Yes Fillable Fileable
Form and Instruction 0920-1175 Environmental Public Health Tracking Work Plan Template Attachment5a_REVISEDJul2018.Environmental Public Health Tracking Work Plan Template (clean).xlsx NA Yes Yes Fillable Fileable

Health Public Health Monitoring

 

26 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 52 0 -52 0 0 104
Annual IC Time Burden (Hours) 1,560 0 -520 0 0 2,080
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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