Information Collection

Incident Report - Gas Distribution System

IC 238176 under ICR 202005-2137-005 · OMB 2137-0635.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2137-0635 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Incident Report - Incident Report - Gas Distribution System	Form and Instruction
Incident Report - Form PHMSA F7100.1 GD Incident Form and Instructions PHMSA F7100.1.pdf www.phmsa.dot.gov	Form and Instruction

IC Title:

Incident Report - Gas Distribution System

Agency IC Tracking Number:

2137-0635

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 191

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	Incident Report - Gas Distribution System	Form PHMSA F7100.1	GD Incident Form and Instructions PHMSA F7100.1.pdf	www.phmsa.dot.gov	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 124

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	Previously Approved
Annual Number of Responses for this IC	124	-26	150
Annual IC Time Burden (Hours)	1,488	-312	1,800
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.