Radiation Exposure Data Collection

Forms and Documents

Document Name	Status
Form DA 7689 Bioassay Information Summary Sheet Form	New
Form DD 1952 Dosimetry Application and Record of Previous Radiation Exposure Form	New
0702-RADS_DraftSORN_10.23.2020.docx Supplementary Document	2021-06-02
0702-RADS_DraftPIA_3.1.2021.pdf Supplementary Document	2021-06-02
Army Regulation 385-10.pdf Supplementary Document	2021-06-02
0702-RADS_SSA_6.14.2021.docx Supporting Statement A	2021-06-14
DA PAM 385-24.pdf Supplementary Document	2021-06-02
DA PAM 385-25.pdf Supplementary Document	2021-06-02

IC Document Collections

IC ID	Document Title	Status
247709	Bioassay Information Summary Sheet Form	New
247663	Dosimetry Application and Record of Previous Radiation Exposure Form	New

ICR Details

OMB Control No:	ICR Reference No: 202105-0702-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: DOD/DOA	Agency Tracking No: 0702-RADS
Title: Radiation Exposure Data Collection
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/14/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	50	0
Time Burden (Hours)	12	0
Cost Burden (Dollars)	374	0

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Abstract: The information collection requirement is to document and record an individual’s external and internal short and long-term exposure to radioactive materials and radiation. The information collection is also utilized to monitor, evaluate and control the risks and associated health hazards, conduct investigations, management studies and training to ensure individual qualifications and education in handling radioactive materials are maintained in compliance with the Nuclear Regulatory Commission (NRC) 10 CFR 20, Army NRC license conditions, and Occupational Safety and Health Administration (OSHA) 29 CFR 1926.53.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 6533	02/05/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 31485	06/14/2021
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Bioassay Information Summary Sheet	DA 7689	Bioassay Information Summary Sheet (BISS)
Dosimetry Application and Record of Previous Radiation Exposure	DD 1952	Dosimetry Application and Record of Previous Radiation Exposure

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ICR Summary of Burden

	Total Request	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	50	0	0	50	0	0
Annual Time Burden (Hours)	12	0	0	12	0	0
Annual Cost Burden (Dollars)	374	0	0	374	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 an existing collection in use without an OMB Control Number.

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Annual Cost to Federal Government: $908

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.     Yes

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.     Yes

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

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Common Form ICR:  No

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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: 06/14/2021

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