Information Collection

Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10

IC 246140 under ICR 202012-2010-001 · OMB 2010-0042.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5800-0012 Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10	Form
Form 5800-0012 Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10 Evaluating Diesel Emissions Reduction Act (DERA) Program Customer Satisfaction in EPA Regions 9 and 10	Form
5800-0012 Evaluating Diesel Emissions Reduction Act (DERA) Program DERA Survey_1-14-2021.docx	Form
5800-0012 Evaluating Diesel Emissions Reduction Act (DERA) Program DERA Survey_1-14-2021.docx	Form
EPA-R9_Generic ICR Clearance Justification_DERA Survey_1-14-2021.docx Justification	IC Document
EPA-R9_Generic ICR Clearance Justification_DERA Survey_1-14-2021.docx Justification	IC Document

IC Title:

Agency IC Tracking Number:

2434.122

IC Status: New

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	5800-0012				Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	900	900
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification		03/08/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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