Household Recruitment Script for Environmental Sampling

Per- or Polyfluoroalkyl Substances Exposure Assessments (PFAS EAs)

OMB: 0923-0059

IC ID: 233859

Information Collection (IC) Details

View Information Collection (IC)

Household Recruitment Script for Environmental Sampling
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Household Recruitment Script for Environmental Sampling PrtApndxA4_HHRecrtScrptEnvSampling_20220609.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

Records of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances   76 FR 4432

70 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 70 0 -47 0 0 117
Annual IC Time Burden (Hours) 6 0 -4 0 0 10
Annual IC Cost Burden (Dollars) 168 0 -70 0 0 238

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

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