1,3-Butadiene Standard (29 CFR 1910.1051)

ICR 201809-1218-006

OMB: 1218-0170

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2019-05-08
Supplementary Document
2018-09-18
Supplementary Document
2018-09-18
Supplementary Document
2018-09-18
IC Document Collections
IC ID
Document
Title
Status
14103 Modified
ICR Details
1218-0170 201809-1218-006
Historical Active 201512-1218-004
DOL/OSHA 1218-0170(2018)SIPIV
1,3-Butadiene Standard (29 CFR 1910.1051)
Revision of a currently approved collection   No
Regular
Approved without change 07/12/2019
Retrieve Notice of Action (NOA) 05/14/2019
  Inventory as of this Action Requested Previously Approved
01/31/2020 6 Months From Approved 07/31/2019
3,649 0 3,649
915 0 915
112,808 0 112,808

The purpose of this standard and its information collection requirements is to provide protection for workers from the adverse health effects associated with occupational exposure to 1,3-Butadiene.

US Code: 29 USC 651 Name of Law: Occupational Safety and Health Act
   US Code: 29 USC 655 Name of Law: Occupational Safety and Health Act
   US Code: 29 USC 657 Name of Law: Occupational Safety and Health Act
  
None

1218-AC67 Final or interim final rulemaking 84 FR 21416 05/14/2019

  81 FR 68504 10/04/2016
81 FR 68504 10/04/2016
No

1
IC Title Form No. Form Name
1,3-Butadiene (29 CFR 1910.1051) 29 CFR 1910.1051 Appendix F Medical Questionnaires (Non-Mandatory); 1,3 Butadiene Initial Health Questionnaire; 1,3-Butadiene Update Health Questionnaire

  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 3,649 3,649 0 0 0 0
Annual Time Burden (Hours) 915 915 0 0 0 0
Annual Cost Burden (Dollars) 112,808 112,808 0 0 0 0
No
No

$0
No
    No
    No
No
No
No
Uncollected
Belinda Cannon 202 693-2083 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/14/2019


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