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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.