Information Collection

Determining Barriers to Hearing Conservation Program Success through Worker Interviews

IC 245719 under ICR 201912-0920-003 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment_B_interview_guide.docx	Other-Interview guide
(1) Attachment-A-Authorizing-Legislation-FederalMineSafety&HealthAct1977.pdf Authorizing legislation	IC Document
Attachment_D_Informed_Consent.docx Consent	IC Document
Attachment_C_recruitment_script.docx Recruitment script	IC Document
Attachment_E_IRB_determination_exempt.pdf IRB determination	IC Document
(8) GenICRequest_HCP_Interviews_02092021rev.docx genIC Request	IC Document
Supporting-Statement-A_HCP_0209021rev.docx Supporting statement A	IC Document
Supporting-Statement-B_HCP_.docx Supporting statement B	IC Document

IC Title:

Determining Barriers to Hearing Conservation Program Success through Worker Interviews

Agency IC Tracking Number:

IC Status: New

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
Other-Interview guide					Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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