Information Collection

Incident Report - Gas Distribution System

IC 238176 under ICR 202205-2137-003 · OMB 2137-0635.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2137-0635 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PHMSA F 7100.1 Incident Report - Gas Distribution System	Form and Instruction
PHMSA F 7100.1 INCIDENT REPORT FOR GAS DISTRIBUTION SYSTEMS GD Incident Form and Instructions - PHMSA F 7100.1 (rev 2021) Clean 2021-1-06.pdf www.phmsa.dot.gov	Form and Instruction
PHMSA F 7100.1 INCIDENT REPORT FOR GAS DISTRIBUTION SYSTEMS GD Incident Form and Instructions - PHMSA F 7100.1 (rev 2021) Clean 2021-1-06.pdf www.phmsa.dot.gov	Form and Instruction

IC Title:

Incident Report - Gas Distribution System

Agency IC Tracking Number:

2137-0635

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 191

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	PHMSA F 7100.1	INCIDENT REPORT FOR GAS DISTRIBUTION SYSTEMS	GD Incident Form and Instructions - PHMSA F 7100.1 (rev 2021) Clean 2021-1-06.pdf	www.phmsa.dot.gov	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 122

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	122	122
Annual IC Time Burden (Hours)	1,464	1,464
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.