Information Collection

Field Work Check-Out Report (private)

IC 242261 under ICR 202302-1024-001 · OMB 1024-0236.

Documents and Forms

Document Name Document Type
Form 10-741D Field Work Check-Out Report (private) Form
10-741D PERMITTEE FIELD CHECK-OUT REPORT Form 10-741D_Permittee Field Work Check-Out Report.pdf Form
10-741D PERMITTEE FIELD CHECK-OUT REPORT Form 10-741D_Permittee Field Work Check-Out Report.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Field Work Check-Out Report (private)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 36 CFR 2.1 and 2.5

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	10-741D	PERMITTEE FIELD CHECK-OUT REPORT	Form 10-741D_Permittee Field Work Check-Out Report.pdf		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 520	Number of Respondents for Small Entity: 520

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Previously Approved
Annual Number of Responses for this IC	520	520
Annual IC Time Burden (Hours)	87	87
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.