Community Drinking Water Monitoring Form

Environmental Public Health Tracking Network (Tracking Network)

OMB: 0920-1175

IC ID: 222532

Documents and Forms
Information Collection (IC) Details

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Community Drinking Water Monitoring Form
 
No Unchanged
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Community Drinking Water Monitoring Form Att4c_CommunityDrinkingWater_Form.doc NA Yes Yes Fillable Fileable

Health Public Health Monitoring

 

30 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 30 0 0 0 0 30
Annual IC Time Burden (Hours) 3,600 0 0 0 0 3,600
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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