Form EIA-851Q Domestic Uranium Production Report (Quarterly)

	U.S. Department of Energy		OMB No. 1905-0160
	U.S. Energy Information Administration		Approval Expires: xx/xx/xxxx
	Washington, DC 20585		Burden: 0.75 hours
	Form EIA-851Q
	Domestic Uranium Production Report (Quarterly)
	xx Quarter 20XX
This report is mandatory under 15 U.S.C. §772 (b). Failure to comply may result in criminal fines, civil penalties and other sanctions as provided by law. For further information concerning sanctions and data protections see the provision on sanctions and the provision concerning the confidentiality of information in the instructions. Title 18 U.S.C. §1001 makes it a criminal offense for any person to knowingly and willingly make to any Agency or Department of the United States any false, fictitious, or fraudulent statements as to any matter within its jurisdiction.		REPORTING BURDEN: Public reporting burden for this collection of information is estimated to average 0.75 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Energy Information Administration, Survey Development and Statistical Integration, EI-21, Forrestal Building, 1000 Independence Avenue S.W., Washington, D.C. 20585-0670; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, D.C. 20503. A person is not required to respond to the collection of information unless the form displays a valid OMB number.
RESPONDENT AND CONTACT IDENTIFICATION
Company Name:		Preparer Name:
Company Address:		Preparer Title:
Company City:		Preparer Company Name:
Company State:		Preparer Address:
Company Zip Code:		Preparer City:
		Preparer State:
Parent Company Name:		Preparer Zip Code:
Parent Company Street Address:		Preparer Phone #:
Parent Company City:		Preparer Fax #:
Parent Company State:		Preparer E-mail Address:
Parent Company Zip Code:
		Supervisor Name:
		Supervisor Title:
		Supervisor Company Name:
		Supervisor Address:
		Supervisor City:
		Supervisor State:
		Supervisor Zip Code:
		Supervisor Phone #:
		Supervisor Fax #:
		Supervisor E-mail Address:
ITEM 1: FACILITY INFORMATION		CONFIDENTIALITY OF INFORMATION: The ‘Respondent Identification’ (Company Name), ‘Item 1: Facility Information’, and production data reported on Form EIA-851Q are considered public information and may be released in company identifiable form. Additional information reported on this form may be protected and may not be disclosed to the public to the extent that it satisfies the criteria for exemption under the Freedom of Information Act (FOIA), 5 U.S.C. 552, the Department of Energy (DOE) regulations, 10 CFR 1004, implementing the FOIA, and the Trade Secrets Act, 18 U.S.C. 1905. The Federal Energy Administration Act requires EIA to provide company-specific data to other Federal agencies when requested for official use. The information reported on this form may also be made available, upon request, to another component of the Department of Energy (DOE); to any Committee of Congress, the Government Accountability Office, or other Federal agencies authorized by law to receive such information. A court of competent jurisdiction may obtain this information in response to an order. The information may be used for any non-statistical purposes such as administrative, regulatory, law enforcement, or adjudicatory purposes. Data protection methods are applied to the statistical information reported on Forms EIA-851Q, except for production data.
Name:
County:
State:
Owner:
Type:
Rated Capacity:
Operating Status:
ITEM 2: PRODUCTION	Pounds U3O8
July-2017
August-2017
September-2017
Total =	0.0
ITEM 3: PRODUCTION SOURCE
Mine name(s)	Pounds U3O8
Other type:	Pounds U3O8
Total =	0.0
COMMENTS