Radon Testing Form

Environmental Public Health Tracking Network (Tracking Network)

Att4f_RadonTesting_Form

Radon Testing

OMB: 0920-1175

Document [docx]
Download: docx | pdf




Shape1

Form Approved

OMB No. 0920-xxxx

Exp. Date xx/xx/201x











Data Dictionary for Data Submission

Radon

National Environmental Public Health Tracking Network

Characteristic

Description

Data Source

Radon testing labs

Purpose

This is a pilot dataset.

Geographic Level


Restrictions

This is a restricted access data set.



Data will be displayed via the national public portal only when sufficient conditions have been met to protect data privacy.






























Shape2

CDC estimates the average public reporting burden for this collection of information as 120 hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).















Data Element

Description

Option

Format

Characters



RadonDataIdentifier

A unique identifier for each batch of Radon Test Result. A batch is test results of multiple locations. Examples are numbers like this: 1034012
1048479 a batch may be an analytical batch; this number in combination with the RadonTestResultIdentifier will be unique.

O

A

 


OPTION R = Required O = Optional

RadonAddressIdentifier

this is a unique ID that can be linked to the address but maintain confidentiality; this number can be linked back to an address

R

A

 



RadonTestResultIdentifier

a unique identifier for each lab result, there may be multiple tests per address, this # will be unique for each test

R

A

 



StateCode

State FIPS code: designator used to identify a principal administrative subdivision of the United States, Canada, or Mexico

R

A

2


FORMAT A = Alphanumeric D = MM/DD/YYYY (date) T = HH:MM (military time)

CountyCode

County FIPS code: represents the county. U = Unknown can be accessed from: https://www.census.gov/geo/reference/codes/cou.html

R

A

5



RadonDataSourceName

The data source where the test data is retrieved (when pulling from multiple data sources). Examples are:
VDH-EH Radon Database
ACCUSTAR
AirCheck
AIRCHEK
ALPHA
AlphaEnergy
EMS
EMSL
Florida Department of Health Radon Program
Kansas Radon Program Data
Landauer
LANDAUERINC
Mitigation
Prolab

R

A

 



MeasureValue

The recorded dimension, capacity, quality, or amount of Radon ascertained by measuring or observing.

R

A

 



MeasureUnitName

The code that represents the unit for measuring the item (Radon test Unit). pCi/L = Picocuries per Liter

R

A

5



TestMethodTypeCode

Identifier of the type or category of method. 1 = pre-mitigation
2 = post-mitigation
NC = not collected

R

A

2



AddressPostalCode

The combination of the 5-digit Zone Improvement Plan (ZIP) code and the four-digit extension code (if available) that represents the geographic segment that is a subunit of the ZIP Code, assigned by the U.S. Postal Service to a geographic location to facilitate mail delivery; or the postal zone specific to the country, other than the U.S., where the mail is delivered.

O/R if no County Code

A

5



CountyName

A name used to identify a primary geopolitical unit of the world.

O

A

 



TestFloorLevelTested

The floor level in the building where the Radon test was conducted. B = Basement
F = Floor Level
F1 = 1st floor
F2 = 2nd floor
F3 = 3rd floor
F4 = Beyond 3rd floor
5 = Other
6 = Unknown
NC = Not Collected

O

A

2



StateName

A name used to identify a principal administrative subdivision of the United States, Canada, or Mexico.

O

A

 



TribalLandName

The name of an American Indian or Alaskan native area where the location address exists.

O

A

 



TribalLandIndicator

An indicator denoting the location address is a tribal land

O

A

 



MunicipalityName

The name of the municipality - incorporated municipality (may be different from city)

O

A

40



LatitudeMeasure

Latitude Measurement (centroid of NJ grid cell) where the Radon Test was conducted.

O

A

10



LongitudeMeasure

Longitude Measurement (centroid of NJ grid cell) where the Radon Test was conducted.

O

A

11



RadonTestBuildingInformation

Information of Radon Test Building

O

A

 

 

 

FoundationTypeCode

A designator used to uniquely identify the Foundation Type that facility occupies. B = Basement
C = Crawlspace
S = Slab-on-grade
P = Pier
O = Other
NC = Not Collected

O

A

10



BuildingPurposeCode

The designator that represents the building purpose. R = Residential
N = Non-residential
ND = Non-residential Daycare
NP = Non-residential daycare center in public school
NS = Non-residential School
NC = Not Collected
C = Community Water Supply
D = Daycare center
P = Daycare center in public school
S = School
U = Unknown

R

A

2



BuildingTypeCode

The designator that represents the Type of the building purpose. R1 = Unattached
R2 = Attached
R3 = Other
NC = Not Collected

O

A

3



BuildingSubTypeCode

The designator that represents the Sub-Type of the building purpose. R1A = Mobile home
R1B = Single level home
R1C = Multi level home
R1D = Other
R2A = Row house
R2B = Town house
R2C = Duplex
R2D = Apartments and Condominiums
NC = Not Collected

O

A

3



TestDeviceLocationText

Specific room in the house where the Radon test was conducted (text) - Master Bedroom
- Bedroom
- Family Room
- Living Room
- Dining Room
- Study/Den
- Basement
- Other

O

A

 



QCCheckTypeCode

Quality Control Checks performed in Radon test. S = D = B =

O

 

 



MitigationSystemIndicator

Indicator of using a Mitigation System. Y = Active System Operating During Test
N = No Active System Operating
U = Unkown-Labs Only
NC = Not Collected

O

A

2



MitigationTypeCode

Specify the type of Mitigation System. ASD = Active Sub-slab Depressurization
ASM = Active Sub-membrane Depressurization
AEU = Air Exchange units
A2A = Air -to-air Heat Exchangers
BWS = Block Wall Suction
CSV = Crawl Space Ventillation
DTV = Drain Tile Ventillation
EAC = Electronic Air Cleaner
FV = Forced Ventillation
GSC = General Sealing Caulking
HRV = Heat Recovery Ventillation
PSD = Passive Sub-slab Depressurization
PSM = Passive Sub-membrane Depressurization
VEN = Ventillation
RFD = Reroute of Furnace Ductwork
SFP = Sealed French Drain/Sump Pump
SFD = Sealed French Drain
SSP = Sealed Sump Pump
OTH = Other
NC = Not Collected

O

A

3



MitigationInstallDate

Specify the Date when the mitigation system was installed

O

D

 



RealEstateTransactionIndicator

Indicator of the building being tested for radon due to a Real Estate transaction or not. Y = Yes
N = No
NC = Not Collected

O

 

2



DeviceTypeName

Name of instrument or equipment used for the Radon test. AC = Activated Charcoal Adsorption
AT = alpha track
ES = Short-term electret
EL = Long-term electret
CR = continuous radon monitor
CW = continuous working level monitor
LS = Charcoal Liquid Scintillation
WL = Working Level
NC = Not Collected CC = Charcoal Canister
GR = Grab Sample – Radon
GW = Grab Sample – Working Level
RP = Radon Progeny Integrated Sampling Unit (RPISU)

O

A

2



DeviceSerialNumberText

Serial number of the device that was used when the radon test was conducted.

O

A

15



PostMitigationMeasure

A Radon test result that occurs after a mitigation system has been installed.

O

A

 



LocationAddressText

The address that describes the physical (geographic) location of the front door or main entrance of a facility site, including urban-style street address or rural address

O

A

 



SupplementalLocationText

The text that provides additional information about a place, including a building name with its secondary unit and number, an industrial park name, an installation name or descriptive text where no formal address is available.

O

A

 



StateCodeListIdentifier

A code designator used to identify a principal administrative subdivision of the United States, Canada, or Mexico

O

A

 



CountryCode

A code designator used to identify a primary geopolitical unit of the world.

O

A

 



CountryCodeListIdentifier

A designator specifying the code set used to provide a country code. Can be used to identify the URL of a source that defines the set of currently approved permitted values.

O

A

 



CountryName

A name used to identify a primary geopolitical unit of the world.

O

A

 



CountyCodeListIdentifier

A designator specifying the code set used to provide a countr code. Can be used to identify the URL of a source that defines the set of currently approved permitted values.

O

A

 



LocationDescriptionText

A brief explanation of a location, including navigational directions and/or more descriptive information.

O

A

 



StatePlaneNorthingYMeasure

Y Measurement where the Radon Test was conducted.

O

A

12



StatePlaneEastingXMeasure

X Measurement where the Radon Test was conducted.

O

A

12



CoordinateTypeCode

Defines whether the coordinates are actual or an estimate. A = Actual E = Estimate

O

A

 



CertifiedContractorIndicator

Indictor if the contractor performing the test is certified or not. Y = Yes
N = No
NC = Not Collected

O

A

2



ContractorName

A designator used to identify the certified/licensed contractor performing the test (company name).

O

A

 



SubstanceName

The name assigned to a chemical, biological or radiological substance or feature that describes it in terms of its molecular composition, taxonomic nomenclature or other characteristic (e.g, Radon test Analyte name)

O

A

 



MitigationInformationText

Mitigation information

O

A

 



LocalityName

The name of a city, town, village or other locality where tested structure is located

O

A

 



Census Tract Placeholder

Placeholder for Census Tract elements

O

A

 



PostMitigationUnitName

Radon test result unit for tests that occur after a mitigation system has been installed. pCi/L = Picocuries per Liter WL = Working Levels

O

A

 










File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorStrosnider, Heather (CDC/ONDIEH/NCEH)
File Modified0000-00-00
File Created2021-01-15

© 2024 OMB.report | Privacy Policy