Information Collection

Drinking Water Information Collection (Public Water Purveyors)

IC 242012 under ICR 202007-0923-001 · OMB 0923-0063.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0063 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Drinking Water Information Collection (Public Water Purveyors)	Form and Instruction
Drinking Water Information Collection Form for Public Wa M_Att3c_WaterInfoCollec_WaterPurveyors_CLEAN.docx	Form and Instruction

IC Title:

Drinking Water Information Collection (Public Water Purveyors)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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
Form and Instruction	n/a	Drinking Water Information Collection Form for Public Water Purveyors	M_Att3c_WaterInfoCollec_WaterPurveyors_CLEAN.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	14	14
Annual IC Time Burden (Hours)	140	140
Annual IC Cost Burden (Dollars)	3,331	3,331

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.