Information Collection

Reporting Health and Safety Data Using Templates

IC 253772 under ICR 202205-2070-003 · OMB 2070-0223.

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Information Collection (IC) Details

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IC Title:	Reporting Health and Safety Data Using Templates	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 717 40 CFR 720 40 CFR 704 40 CFR 707 40 CFR 716 40 CFR 721 40 CFR 723 40 CFR 725 40 CFR 790

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 350	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to New Statute
Annual Number of Responses for this IC	4,900	4,900
Annual IC Time Burden (Hours)	245	245
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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