Information Collection

Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms

IC 266192 under ICR 202106-2030-001 · OMB 2030-0051.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2030-0051 can be found here:

2024-06-28 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 6700-013 Public Health Seattle & King County EPA Outreach Event Survey Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
Form 6700-014 Moms and Caregivers Self-Assessment (Multiple Languages) Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
Form 6700-015 Moms and Caregivers Pledges (Multiple Languages) Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
Form 6700-016 Moms and Caregivers Mini Quiz (Multiple Languages) Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
Form 6700-017 Moms and Caregivers Background Survey (Multiple Languages) Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
Form 6700-018 Fishers Workshop PRE-Survey (Multiple Languages) Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
Form 6700-019 Fishers Workshop POST-Survey (Multiple Languages) Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
Form 6700-020 Fishers Workshop Pledges (Multiple languages) Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
Form 6700-021 CHA Behavior Survey Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
Form 6700-022 Pre-Assessment of CHAs-in-Training Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
Form 6700-023 Post-Assessment of CHAs-in-Training Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Form
6700-013 Public Health Seattle & King County EPA Outreach Event S 2024_OutreachEventSurvey.pdf	Form
6700-014 Moms and Caregivers Self-Assessment (Multiple Languages) 2024_MomsWG_SelfAssessment.pdf	Form
6700-015 Moms and Caregivers Pledges (Multiple Languages) 2024_MomsWG_Pledges.pdf	Form
6700-016 Moms and Caregivers Mini Quiz (Multiple Languages) 2024_MomsWG_MiniQuiz.pdf	Form
6700-017 Moms and Caregivers Background Survey (Multiple Language 2024_MomsWG_BackgroundSurvey.pdf	Form
6700-018 Fishers Workshop PRE-Survey (Multiple Languages) 2024_FishersWG_PreSurvey.pdf	Form
6700-019 Fishers Workshop POST-Survey (Multiple Languages) 2024_FishersWG_PostSurvey.pdf	Form
6700-020 Fishers Workshop Pledges (Multiple languages) 2024_FishersWG_Pledges.pdf	Form
6700-021 CHA Behavior Survey 2024_CHABehaviorSurvey.pdf	Form
6700-022 Pre-Assessment of CHAs-in-Training 2024_PREcurric_Final.pdf	Form
6700-023 Post-Assessment of CHAs-in-Training 2024_POSTcurric_FINAL.pdf	Form
R10_Lower Duwamish Waterway ICIAP Program Eval_Generic Customer Service Collection Request.docx Justification	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms

Agency IC Tracking Number:

2434.211

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	6700-013	Yes	Yes	Fillable Fileable
Form	6700-014	Yes	Yes	Fillable Fileable
Form	6700-015	Yes	Yes	Fillable Fileable
Form	6700-016	Yes	Yes	Fillable Fileable
Form	6700-017	Yes	Yes	Fillable Fileable
Form	6700-018	Yes	Yes	Fillable Fileable
Form	6700-019	Yes	Yes	Fillable Fileable
Form	6700-020	Yes	Yes	Fillable Fileable
Form	6700-021	Yes	Yes	Fillable Fileable
Form	6700-022	Yes	Yes	Fillable Fileable
Form	6700-023	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 675

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	675	675
Annual IC Time Burden (Hours)	323	323
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification		03/21/2024

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

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