Information Collection

Clean Watersheds Needs Survey - State Facilities

IC 23592 under ICR 202109-2040-001 · OMB 2040-0050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2040-0050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix A - CWNS DEP Screenshots and Small Community Form_June 2021.pdf cwnsdep.epa.gov/	Other-Data Entry Portal Screenshots
Appendix A - CWNS DEP Screenshots and Small Community Form_June 2021.pdf cwnsdep.epa.gov/	Other-Data Entry Portal Screenshots
Appendix B - CWNS Excel Annotation and Needs Calculation Workbook_June 2021.pdf	Other-CWNS Excel Annotation and Need
Appendix B - CWNS Excel Annotation and Needs Calculation Workbook_June 2021.pdf	Other-CWNS Excel Annotation and Need
Appendix C - CWNS Small Community Form.pdf	Other-Small Form Community Wireframe
Appendix C - CWNS Small Community Form.pdf	Other-Small Form Community Wireframe

IC Title:

Clean Watersheds Needs Survey - State Facilities

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Data Entry Portal Screenshots & Wireframes	Appendix A - CWNS DEP Screenshots and Small Community Form_June 2021.pdf	https://cwnsdep.epa.gov/	Yes	Yes	Fillable Fileable Signable
Other-CWNS Excel Annotation and Needs Calculation Workbook	Appendix B - CWNS Excel Annotation and Needs Calculation Workbook_June 2021.pdf		Yes	Yes	Fillable Fileable Signable
Other-Small Form Community Wireframes	Appendix C - CWNS Small Community Form.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	56	56
Annual IC Time Burden (Hours)	7,864	7,864
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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