Information Collection Request

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Renewal)

ICR 202012-2010-001 · OMB 2010-0042 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 5800-050 Viburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey Form New Available
Form 5800-050 Viburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey Form New Repair queued
Form 5800-049 Site User Satisfaction Survey Form New Available
Form 5800-049 Great Lakes AOC Project Area Community Use and Benefits Site User Satisfaction Survey Form New Repair queued
Form 5800-048 e-Manifest Electronic Manifest Questionnaire Form New Available
Form 5800-048 e-Manifest Electronic Manifest Questionnaire Form New Repair queued
Form 5800-047 Water Quality Standards Academy Evaluation Form Form New Available
Form 5800-047 EPA Water Quality Standards Academy Student Course Evaluation Form New Repair queued
Form 5800-046 2021 TRI Website Satisfaction Survey Form New Available
Form 5800-046 Toxics Release Inventory (TRI) Program Website Customer Satisfaction Survey Form New Repair queued
Form 5800-045 RY 2020 TRI-MEweb Application User Survey Form New Available
Form 5800-045 TRI-MEweb Customer Survey (Toxic Release Inventory – Made Easy Web) Form New Repair queued
Form 5800-044 Conference Evaluation Form 27th National Tanks Conference and Expo Form New Available
Form 5800-043 Individual Session Evaluation Form 27th National Tanks Conference and Expo Form New Available
Form 5800-043 Evaluation Forms for the National Tanks Conference and Expo Form New Repair queued
Form 2010-0042 Survey of Certification Plan and Reporting Database Users – Evaluating User Access Form New Available
Form 2010-0042 Survey of Certification Plan and Reporting Database Users – Evaluating User Access Form New Repair queued
Form 5800-042 EPA's Small Drinking Water Systems Webinar Series Survey Form New Available
Form 5800-042 Office of Research and Development/Office of Water (ORD/OW) Small Systems Webinar Series Attendee Survey of Satisfaction Form New Repair queued
Form 5800-041 ORD State Engagement Feedback Survey Form New Available
Form 5800-041 Customer Satisfaction Survey for State Government Officials that Participated in the Office of Research and Development's FY2019-2022 Strategic Research Planning and Implementation Process Form New Repair queued
Form 5800-011 Science Matters Survey Form New Available
Form 5800-011 Office of Research and Development Science Matters Newsletter Customer Satisfaction Survey Form New Repair queued
Form 5800-010 Helpdesk Customer Satisfaction Survey for the Integrated Compliance Information System (ICIS) and the National Pollutant Discharge Elimination System (NPDES) eReporting Tools (NeT, NeTDMR) Form New Available
Form 5800-010 Helpdesk Customer Satisfaction Survey for the Integrated Compliance Information System (ICIS) and the National Pollutant Discharge Elimination System (NPDES) eReporting Tools (NeT, NeTDMR) Form New Repair queued
Form 5800-040 HEALTHIER SCHOOL ENVIRONMENTS WORKSHOP CUSTOMER SATISFACTION SURVEY Form New Available
Form 5800-040 Customer Satisfaction Survey for Healthier School Environments Workshops Form New Repair queued
Form 5800-039 Guest Speaker Survey Form New Available
Form 5800-039 Guest Speaker Survey Form New Repair queued
Form 5800-14 Discussion Guide Form and Instruction New Available
Form 5800-015 Final Screener Form and Instruction New Repair queued
Form 5800-015 Pretesting Outreach and Web Materials for Fish Consumption Advisories Form and Instruction New Repair queued
Form 5800-013 Los Angeles Public Library Patron Air Sensor Loan Survey Form New Available
Form 5800-013 Evaluating the Pilot Los Angeles Public Library Sensor Loan Program: Patron Air Sensor Use Component Form New Repair queued
Form 5800-003 Customer Service Survey Form New Available
Form 5800-003 EPA Docket Center Customer Satisfaction Survey Form New Repair queued
Form 5800-007 EnviroAtlas Survey Form New Available
Form 5800-007 EnviroAtlas Survey Form New Available
Form 5800-016 EJScreen 2022 Impact Survey Form New Available
Form 5800-016 EJScreen 2022 Impact Survey Form New Repair queued
Form 5800-038 eGRID User Satisfaction Survey Form New Available
Form 5800-038 eGRID Customer Satisfaction Survey Form New Repair queued
Form 5800-037 ECHO Post Training Survey Questions Form New Available
Form 5800-037 ECHO Post Training Survey Questions Form New Repair queued
Form 5800-036 Training Evaluation Survey Form New Available
Form 5800-035 Meeting Facilitation Questionnaire Form New Available
Form 5800-034 Long Term Group Facilitation Participant Questionnaire Form New Available
Form 5800-033 Follow-up Effects Survey Participant Judicial Proceeding Form New Available
Form 5800-032 Follow-up Effects Survey Participant Agency Decision Form New Available
Form 5800-031 Follow-up Effects Survey Participant Administrative Proceeding Form New Available
Form 5800-030 Follow-up Effects Survey Case Lead Judicial Proceeding Form New Available
Form 5800-029 Follow-up Effects Survey Case Lead Agency Decision Form New Available
Form 5800-028 Follow-up Effects Survey Case Lead Administrative Proceeding Form New Available
Form 5800-027 Facilitated Dialogue Participant Questionnaire Form New Available
Form 5800-026 Agreement Seeking Participant Judicial Proceeding Evaluation Survey Form New Available
Form 5800-025 Agreement Seeking Participant Agency Decision Evaluation Survey Form New Available
Form 5800-024 Agreement Seeking Participant Administrative Proceeding Evaluation Survey Form New Available
Form 5800-023 Agreement Seeking Case Lead Judicial Proceeding Evaluation Survey Form New Available
Form 5800-022 Agreement Seeking Case Lead Agency Decision Evaluation Survey Form New Available
Form 5800-020 Agreement Seeking Case Lead Administrative Proceeding Evaluation Survey Form New Available
Form 5800-020 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form New Repair queued
Form 5800-0012 Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10 Form New Available
Form 5800-0012 Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10 Form New Repair queued
Form 6200-021 America Recycles 2020 Event Survey & Pledge Signer Input Form New Available
Form 6200-021 Customer Satisfaction Survey for the America Recycles Events Form New Repair queued
Form 5800-020 EPA Tools & Resources Webinar Series and EPA Science Training Webinars Evaluation Form Form and Instruction New Available
Form 5800-020 Office of Research & Development's EPA Tools & Resources Webinar Series and EPA Science Training Webinars - Attendee Satisfaction Survey Form and Instruction New Available
Form 5800-019 CDX Help Desk Survey Form and Instruction New Available
Form 5800-019 Central Data Exchange (CDX) Help Desk Survey Form and Instruction New Repair queued
Form 5800-018 CDX Customer Satisfaction with Program Services Form and Instruction New Available
Form 5800-018 Central Data Exchange (CDX) Customer Satisfaction Survey Form and Instruction New Repair queued
Form 5800-017 User Survey Form New Available
Form 5800-017 Office of Administrative Law Judges Alternative Dispute Resolution Process User Survey Form New Repair queued
Instructions & Template for Generic Customer Service Collection Request.docx Supplementary Document Uploaded 2021-03-31 Repair queued
2434ss99.docx Supporting Statement A Uploaded 2021-03-31 Repair queued
2434ss99.docx Supporting Statement B Uploaded 2021-03-31 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
246508 Survey Soliciting Input for Vision 2032 Plan Other-Survey Questions New
246393 Viburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey Form NewViburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey
246393 Viburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey Form New
246262 Great Lakes AOC Project Area Community Use and Benefits Site User Satisfaction Survey Form NewSite User Satisfaction Survey
246262 Great Lakes AOC Project Area Community Use and Benefits Site User Satisfaction Survey Form New
246261 e-Manifest Electronic Manifest Questionnaire Form Newe-Manifest Electronic Manifest Questionnaire
246261 e-Manifest Electronic Manifest Questionnaire Form New
246231 EPA Water Quality Standards Academy Student Course Evaluation Form NewWater Quality Standards Academy Evaluation Form
246231 EPA Water Quality Standards Academy Student Course Evaluation Form New
246228 Toxics Release Inventory (TRI) Program Website Customer Satisfaction Survey Form New2021 TRI Website Satisfaction Survey
246228 Toxics Release Inventory (TRI) Program Website Customer Satisfaction Survey Form New
246222 TRI-MEweb Customer Survey (Toxic Release Inventory – Made Easy Web) Form NewRY 2020 TRI-MEweb Application User Survey
246222 TRI-MEweb Customer Survey (Toxic Release Inventory – Made Easy Web) Form New
246221 Evaluation Forms for the National Tanks Conference and Expo Form NewConference Evaluation Form 27th National Tanks Conference and Expo
246221 Evaluation Forms for the National Tanks Conference and Expo Form NewIndividual Session Evaluation Form 27th National Tanks Conference and Expo
246221 Evaluation Forms for the National Tanks Conference and Expo Form New
246220 Survey of Certification Plan and Reporting Database Users – Evaluating User Access Form NewSurvey of Certification Plan and Reporting Database Users – Evaluating User Access
246220 Survey of Certification Plan and Reporting Database Users – Evaluating User Access Form New
246219 Office of Research and Development/Office of Water (ORD/OW) Small Systems Webinar Series Attendee Survey of Satisfaction Form NewEPA's Small Drinking Water Systems Webinar Series Survey
246219 Office of Research and Development/Office of Water (ORD/OW) Small Systems Webinar Series Attendee Survey of Satisfaction Form New
246203 Customer Satisfaction Survey for State Government Officials that Participated in the Office of Research and Development's FY2019-2022 Strategic Research Planning and Implementation Process Form NewORD State Engagement Feedback Survey
246203 Customer Satisfaction Survey for State Government Officials that Participated in the Office of Research and Development's FY2019-2022 Strategic Research Planning and Implementation Process Form New
246201 Office of Research and Development Science Matters Newsletter Customer Satisfaction Survey Form NewScience Matters Survey
246201 Office of Research and Development Science Matters Newsletter Customer Satisfaction Survey Form New
246198 Helpdesk Customer Satisfaction Survey for the Integrated Compliance Information System (ICIS) and the National Pollutant Discharge Elimination System (NPDES) eReporting Tools (NeT, NeTDMR) Form NewHelpdesk Customer Satisfaction Survey for the Integrated Compliance Information System (ICIS) and the National Pollutant Discharge Elimination System (NPDES) eReporting Tools (NeT, NeTDMR)
246198 Helpdesk Customer Satisfaction Survey for the Integrated Compliance Information System (ICIS) and the National Pollutant Discharge Elimination System (NPDES) eReporting Tools (NeT, NeTDMR) Form New
246196 Customer Satisfaction Survey for Healthier School Environments Workshops Form NewHEALTHIER SCHOOL ENVIRONMENTS WORKSHOP CUSTOMER SATISFACTION SURVEY
246196 Customer Satisfaction Survey for Healthier School Environments Workshops Form New
246190 Guest Speaker Survey Form NewGuest Speaker Survey
246190 Guest Speaker Survey Form New
246189 Pretesting Outreach and Web Materials for Fish Consumption Advisories Form and Instruction NewDiscussion Guide
246189 Pretesting Outreach and Web Materials for Fish Consumption Advisories Form and Instruction NewFinal Screener
246189 Pretesting Outreach and Web Materials for Fish Consumption Advisories Form and Instruction New
246188 Evaluating the Pilot Los Angeles Public Library Sensor Loan Program: Patron Air Sensor Use Component Form NewLos Angeles Public Library Patron Air Sensor Loan Survey
246188 Evaluating the Pilot Los Angeles Public Library Sensor Loan Program: Patron Air Sensor Use Component Form New
246184 EPA Docket Center Customer Satisfaction Survey Form NewCustomer Service Survey
246184 EPA Docket Center Customer Satisfaction Survey Form New
246183 EnviroAtlas Survey Form NewEnviroAtlas Survey
246183 EnviroAtlas Survey Form New
246181 EJScreen 2022 Impact Survey Form NewEJScreen 2022 Impact Survey
246181 EJScreen 2022 Impact Survey Form New
246180 eGRID Customer Satisfaction Survey Form NeweGRID User Satisfaction Survey
246180 eGRID Customer Satisfaction Survey Form New
246178 ECHO Post Training Survey Questions Form NewECHO Post Training Survey Questions
246178 ECHO Post Training Survey Questions Form New
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewTraining Evaluation Survey
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewMeeting Facilitation Questionnaire
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewLong Term Group Facilitation Participant Questionnaire
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewFollow-up Effects Survey Participant Judicial Proceeding
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewFollow-up Effects Survey Participant Agency Decision
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewFollow-up Effects Survey Participant Administrative Proceeding
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewFollow-up Effects Survey Case Lead Judicial Proceeding
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewFollow-up Effects Survey Case Lead Agency Decision
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewFollow-up Effects Survey Case Lead Administrative Proceeding
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewFacilitated Dialogue Participant Questionnaire
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewAgreement Seeking Participant Judicial Proceeding Evaluation Survey
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewAgreement Seeking Participant Agency Decision Evaluation Survey
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewAgreement Seeking Participant Administrative Proceeding Evaluation Survey
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewAgreement Seeking Case Lead Judicial Proceeding Evaluation Survey
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewAgreement Seeking Case Lead Agency Decision Evaluation Survey
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form NewAgreement Seeking Case Lead Administrative Proceeding Evaluation Survey
246141 Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA Form New
246140 Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10 Form NewEvaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10
246140 Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10 Form New
246139 Customer Satisfaction Survey for the America Recycles Events Form NewAmerica Recycles 2020 Event Survey & Pledge Signer Input
246139 Customer Satisfaction Survey for the America Recycles Events Form New
246129 Office of Research & Development's EPA Tools & Resources Webinar Series and EPA Science Training Webinars - Attendee Satisfaction Survey Form and Instruction NewEPA Tools & Resources Webinar Series and EPA Science Training Webinars Evaluation Form
246129 Office of Research & Development's EPA Tools & Resources Webinar Series and EPA Science Training Webinars - Attendee Satisfaction Survey Form and Instruction New
246127 Central Data Exchange (CDX) Help Desk Survey Form and Instruction NewCDX Help Desk Survey
246127 Central Data Exchange (CDX) Help Desk Survey Form and Instruction New
246125 Central Data Exchange (CDX) Customer Satisfaction Survey Form and Instruction NewCDX Customer Satisfaction with Program Services
246125 Central Data Exchange (CDX) Customer Satisfaction Survey Form and Instruction New
246087 Office of Administrative Law Judges Alternative Dispute Resolution Process User Survey Form NewUser Survey
246087 Office of Administrative Law Judges Alternative Dispute Resolution Process User Survey Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2024 36 Months From Approved 05/31/2021
180,000 0 120,000
45,000 0 30,000
0 0 0





Reginfo record details
29
table that charts list of burden
IC Title Form No. Form Name
Central Data Exchange (CDX) Customer Satisfaction Survey 5800-018
Central Data Exchange (CDX) Help Desk Survey 5800-019
Customer Satisfaction Survey for Healthier School Environments Workshops 5800-040
Customer Satisfaction Survey for State Government Officials that Participated in the Office of Research and Development's FY2019-2022 Strategic Research Planning and Implementation Process 5800-041
Customer Satisfaction Survey for the America Recycles Events 6200-021
ECHO Post Training Survey Questions 5800-037
EJScreen 2022 Impact Survey 5800-016
EPA Docket Center Customer Satisfaction Survey 5800-003
EPA Water Quality Standards Academy Student Course Evaluation 5800-047
EnviroAtlas Survey 5800-007
Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10 5800-0012
Evaluating the Pilot Los Angeles Public Library Sensor Loan Program: Patron Air Sensor Use Component 5800-013
Evaluation Forms for the National Tanks Conference and Expo 5800-043, 5800-044 ,  
Evaluation of Environmental Collaboration and Conflict Resolution (ECCR) Services and Training at EPA 5800-034, 5800-035, 5800-036, 5800-022, 5800-020, 5800-024, 5800-023, 5800-025, 5800-026, 5800-027, 5800-029, 5800-030, 5800-032, 5800-033, 5800-028, 5800-031 ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
Great Lakes AOC Project Area Community Use and Benefits Site User Satisfaction Survey 5800-049
Guest Speaker Survey 5800-039
Helpdesk Customer Satisfaction Survey for the Integrated Compliance Information System (ICIS) and the National Pollutant Discharge Elimination System (NPDES) eReporting Tools (NeT, NeTDMR) 5800-010
Office of Administrative Law Judges Alternative Dispute Resolution Process User Survey 5800-017
Office of Research & Development's EPA Tools & Resources Webinar Series and EPA Science Training Webinars - Attendee Satisfaction Survey 5800-020
Office of Research and Development Science Matters Newsletter Customer Satisfaction Survey 5800-011
Office of Research and Development/Office of Water (ORD/OW) Small Systems Webinar Series Attendee Survey of Satisfaction 5800-042
Pretesting Outreach and Web Materials for Fish Consumption Advisories 5800-015, 5800-14 ,  
Survey Soliciting Input for Vision 2032 Plan
Survey of Certification Plan and Reporting Database Users – Evaluating User Access 2010-0042
TRI-MEweb Customer Survey (Toxic Release Inventory – Made Easy Web) 5800-045
Toxics Release Inventory (TRI) Program Website Customer Satisfaction Survey 5800-046
Viburnum Trend Lead Haul Roads, Operable Unit 2 – St. Joe Minerals Corp, City of Viburnum Superfund Site Community Survey 5800-050
e-Manifest Electronic Manifest Questionnaire 5800-048
eGRID Customer Satisfaction Survey 5800-038

table that charts list 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 180,000 120,000 0 0 60,000 0
Annual Time Burden (Hours) 45,000 30,000 0 0 15,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No