Information Collection

RadNet - Drinking Water

IC 178892 under ICR 201911-2060-012 · OMB 2060-0015.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2060-0015 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5900-23 RadNet Supply Request Form RadNet - Drinking Water	Form
Form 5900-29 RadNet Drinking Water Report RadNet - Drinking Water	Form
Form 5900-23 RadNet - Drinking Water	Form
5900-23 RadNet Supply Request Form Form 5900-23 - RadNet Supply Request Form.pdf	Form
5900-29 RadNet Drinking Water Report Form 5900-29 - RadNet Drinking Water Report Form.pdf	Form
5900-23 RadNet Supply request Form RadNet Supply Request Form.pdf	Form
5900-29 RadNet Drinking Water Report RadNet Drinking Water Report.pdf	Form

IC Title:

RadNet - Drinking Water

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5900-23				Yes	No	Fillable Printable
Form	5900-29				Yes	No	Fillable Printable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 68

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	272	260	12
Annual IC Time Burden (Hours)	168	10	158
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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