Filter Adoption Survey (New)

Forms and Documents

Document Name	Status
Form 6700-009 Filter Adoption Survey by Denver Water - Customers Form and Instruction	New
2615ssBrevised01.docx Supporting Statement B	2020-09-09
2615ssArevised01.docx Supporting Statement A	2020-09-09

IC Document Collections

IC ID	Document Title	Status
242635	Filter Adoption Survey by Denver Water - Denver Water	New
242634	Filter Adoption Survey by Denver Water - Customers Form and Instruction	New

ICR Details

OMB Control No: 2008-0003	ICR Reference No: 202007-2008-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: EPA/RODENVER	Agency Tracking No: 2615.01
Title: Filter Adoption Survey (New)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/10/2020
	Date Received in OIRA: 07/15/2020
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2023	36 Months From Approved
Responses	2,001	0	0
Time Burden (Hours)	1,270	0	0
Cost Burden (Dollars)	1,000	0	0

---

Abstract: The U.S. EPA granted Denver Water a SDWA 1415(a)(3) variance from the definition of optimal corrosion control treatment in 40 CFR 141.2. The Variance contains requirements to determine the efficacy of the filter program. EPA will use the survey results that Denver Water annually distributes, to determine the consumer filter adoption rate, and to confirm whether customers are using and maintaining the filters correctly, and per manufacturers instructions.

---

Authorizing Statute(s): US Code: 42 USC 300f. Name of Law: Safe Drinking Water Act (SDWA)
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 14477	03/12/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 41582	07/10/2020
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Filter Adoption Survey by Denver Water - Customers	6700-009, 6700-009	Filter Adoption Survey ,   Filter Adoption Survey
Filter Adoption Survey by Denver Water - Denver Water

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,001	0	0	2,001	0	0
Annual Time Burden (Hours)	1,270	0	0	1,270	0	0
Annual Cost Burden (Dollars)	1,000	0	0	1,000	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection.

---

Annual Cost to Federal Government: $864

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/15/2020

---