Attachment 5 – Intervention Log
Intervention Log
Form Approved
OMB No. 0920-1227
CDC estimates the average
public reporting burden for this collection of information as 30
minutes per response, including the time for reviewing instructions,
searching existing data/information sources, gathering and
maintaining the data/information needed, and completing and
reviewing the collection of information. An agency may not conduct
or sponsor, and a person is not required to respond to a collection
of information unless it displays a currently valid OMB control
number. Send comments regarding this burden estimate to: CDC/ATSDR
Information Collection Review Office, MS D-74, 1600 Clifton Road,
NE, Atlanta, GA 30333 ATTN: PRA (0920-1227).
|
Restaurant Code
|
Y N |
Was an intervention provided on this visit
|
|
Date
|
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | CDC User |
| File Modified | 0000-00-00 |
| File Created | 2021-02-14 |