Att H_ Initial Site Visit Followback Survey Form

Health Hazard Evaluations/Technical Assistance and Emerging Problems

OMB: 0920-0260

IC ID: 185720

Information Collection (IC) Details

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Att H_ Initial Site Visit Followback Survey Form 0920-0260
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0260 Initial Site Visit Followback Survey Form Attachment_H.docx No   Paper Only

Health Illness Prevention

Occupational Health Epidemiological Studies  76 FR 34706

140 115
   
Private Sector Businesses or other for-profits, Farms, Not-for-profit institutions
 
   0 %

  Requested 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 140 0 -104 0 0 244
Annual IC Time Burden (Hours) 23 0 -18 0 0 41
Annual IC Cost Burden (Dollars) 797 0 -591 0 0 1,388

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