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Periodic Medical Surveillance Examinations for Coal Miners
Periodic Medical Surveillance Examinations for Coal Miners
OMB: 1219-0152
IC ID: 209661
OMB.report
DOL/MSHA
OMB 1219-0152
ICR 202303-1219-006
IC 209661
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Periodic Medical Surveillance Examinations for Coal Miners
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
30 CFR 72.100(e)
30 CFR 72.100(d)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Worker Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
664
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
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
797
0
-555
0
0
1,352
Annual IC Time Burden (Hours)
310
0
-739
0
0
1,049
Annual IC Cost Burden (Dollars)
239
0
-167
0
0
406
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.