Information Collection

Application for Waiver of Surface Sanitary Facilities Requirements (Pertaining to Coal Mines)

IC 14379 under ICR 202002-1219-004 · OMB 1219-0024.

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Information Collection (IC) Details

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IC Title:	Application for Waiver of Surface Sanitary Facilities Requirements (Pertaining to Coal Mines)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 71.404 30 CFR 75.1712-4 30 CFR 75.1712-5 30 CFR 71.403

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 525	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	525	-206	731
Annual IC Time Burden (Hours)	232	-69	301
Annual IC Cost Burden (Dollars)	2,625	-1,030	3,655

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