Information Collection

Asbestos in General Industry (29 CFR 1910.1001)

IC 14073 under ICR 201809-1218-010 · OMB 1218-0133.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0133 can be found here:

Documents and Forms

Document Name Document Type
Form Appendix D to 1910 Asbestos in General Industry (29 CFR 1910.1001) Form and Instruction
Appendix D to 1910 Medical Questionnaires, Mandatory SIP IV Final Rule - Asbestos in General Industry Appendix D Public Burden Statement (03.26.19).docx Form and Instruction
asbestos in gen industry app d mark-up 03.25.19.pdf Appendix D mark-up IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Asbestos in General Industry (29 CFR 1910.1001)	Agency IC Tracking Number:	1218-0133(2018)SIPIV

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1910.1001

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Appendix D to 1910.1001	Medical Questionnaires, Mandatory	SIP IV Final Rule - Asbestos in General Industry Appendix D Public Burden Statement (03.26.19).docx		No		Printable Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 121	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	32,171	-2	32,173
Annual IC Time Burden (Hours)	11,688	0	11,688
Annual IC Cost Burden (Dollars)	963,650	0	963,650

Documents for IC

Title	Document	Date Uploaded
Appendix D mark-up	asbestos in gen industry app d mark-up 03.25.19.pdf	03/25/2019

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