Information Collection

Form A Submissions

IC 235747 under ICR 201911-2070-003 · OMB 2070-0210.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2070-0210 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 9600-05 Form A Submissions	Form and Instruction
9600-05 Form A NOA form A (10-29-19) revised.pdf	Form and Instruction

IC Title:

Form A Submissions

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 710

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 and Instruction	9600-05	Form A	NOA form A (10-29-19) revised.pdf		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 275

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,995	1,995
Annual IC Time Burden (Hours)	374	374
Annual IC Cost Burden (Dollars)	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.