Information Collection Request

ATSDR Exposure Investigations (EIs)

ICR 202112-0923-002 · OMB 0923-0048 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0923-0048 Jasper and Newton Counties Missouri Lead Exposure Investigation Form and Instruction New Available
Att7_EI Program Determination 2021.pdf Supplementary Document Uploaded 2022-03-14 Repair queued
Att6 0923-0048 PIA 20220209.pdf Supplementary Document Uploaded 2022-03-14 Repair queued
Att5_Example AssentConsentParental Permission.docx Supplementary Document Uploaded 2022-03-14 Repair queued
Att4 Chem Exp Question Bank 0923_0048.docx Supplementary Document Uploaded 2022-03-14 Repair queued
Att3 EI Map 20130430.pdf Supplementary Document Uploaded 2022-03-14 Repair queued
Att2 ATSDR-0923-0048_60-day FRN.pdf Supplementary Document Uploaded 2022-03-14 Repair queued
Att1 AuthLegsl 20151118.docx Supplementary Document Uploaded 2022-03-14 Missing upstream
ATSDR SSB_EI Extension 0923-0048 20221217.docx Supporting Statement B Uploaded 2022-03-14 Repair queued
ATSDR SSA_EI Extension 0923-0048 20211217.docx Supporting Statement A Uploaded 2022-03-14 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
254359 Jasper and Newton Counties Missouri Lead Exposure Investigation Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 04/30/2022
3,600 3,600
1,800 1,800
0 0






table that charts list 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 3,600 3,600 0 0 0 0
Annual Time Burden (Hours) 1,800 1,800 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No