Information Collection Request

Radiation Sampling and Exposure Records

ICR 202303-1219-001 · OMB 1219-0003 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form MSHA 4000-9 Radiation Sampling and Exposure Records Form and Instruction Modified Repair queued
1219-0003 Published 60 Day FRN 3-21-2023.pdf Supplementary Document Uploaded 2023-08-28 Repair queued
1219-0003 Supporting Statement 2023.docx Supporting Statement A Uploaded 2023-08-28 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
14336 Radiation Sampling and Exposure Records Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 10/31/2023
404 404
402 402
20 20





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Radiation Sampling and Exposure Records MSHA 4000-9 Record of Individual Exposure to Radon Daughters

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 404 404 0 0 0 0
Annual Time Burden (Hours) 402 402 0 0 0 0
Annual Cost Burden (Dollars) 20 20 0 0 0 0


Reginfo record details
  No