Information Collection

[ATSDR] Environmental Health and Land Reuse (EHLR) Immersion Training Pilots

IC 258593 under ICR 202110-0923-002 · OMB 0923-0047.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
[ATSDR] Environmental Health and Land Reuse (EHLR) Immersion Training Pilots	Form and Instruction
AttA-EHLR-Pilot-TrainingRegistForm (Word).docx	Other-WORD
ATT-B-EHLRImm-KnowlAssmt-Pilot (Word).docx	Other-WORD
AttC-EHLR-Pilot-FeedbkForm (Word).docx	Other-WORD
EHLR Training Registration-Pilots ATT-A-EHLRT-Pilot RegistFrm (REDCap).pdf	Form and Instruction
EHLR Immersion Community Engagement Knowledge Assessment ATT-B-EHLRImm-KnowlAssmt-Pilot (REDCap).pdf	Form and Instruction
EHLR Immersion Pilot Training Feedback Form AttC-EHLR-Pilot-FeedbkForm (REDCap).pdf	Form and Instruction
GenIC-EHLR-Immersion-Pilot.docx GenIC Request Template (Project Description and Justification for EHLR Training Pilots Feedback)	IC Document
AttD-STARS Determination-EHLR.pdf CDC Determination: IRB Approval is Not Required	IC Document

IC Title:

[ATSDR] Environmental Health and Land Reuse (EHLR) Immersion Training Pilots

Agency IC Tracking Number:

0923-23CT

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	EHLR Training Registration-Pilots	ATT-A-EHLRT-Pilot RegistFrm (REDCap).pdf	Yes	Yes	Fillable Fileable
Form and Instruction	None	EHLR Immersion Community Engagement Knowledge Assessment	ATT-B-EHLRImm-KnowlAssmt-Pilot (REDCap).pdf	Yes	Yes	Fillable Fileable
Form and Instruction	None	EHLR Immersion Pilot Training Feedback Form	AttC-EHLR-Pilot-FeedbkForm (REDCap).pdf	Yes	Yes	Fillable Fileable
Other-WORD			AttA-EHLR-Pilot-TrainingRegistForm (Word).docx	No		Printable Only
Other-WORD			ATT-B-EHLRImm-KnowlAssmt-Pilot (Word).docx	No		Printable Only
Other-WORD			AttC-EHLR-Pilot-FeedbkForm (Word).docx	No		Printable Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: CDC/ATSDR Trainee Records (SORN 09-20-0161)

FR Citation: 86 FR 16212

Number of Respondents: 100

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	100	100
Annual IC Time Burden (Hours)	47	47
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC Request Template (Project Description and Justification for EHLR Training Pilots Feedback)	GenIC-EHLR-Immersion-Pilot.docx	02/17/2023
CDC Determination: IRB Approval is Not Required	AttD-STARS Determination-EHLR.pdf	02/17/2023

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