Form NIST-366A: Request for Personal Radiation Monitoring Services

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form NIST-366A Request for Personal Radiation Monitoring Services	Form	Modified	Available
Form NIST-366A Form NIST-366A: Request for Personal Radiation Monitoring Services	Form	Modified	Repair queued
Supporting Statement_NIST 366A - 2023 Final.docx	Supporting Statement A	Uploaded 2023-06-27	Repair queued
10 CFR 20.1502 Citation.docx	Supplementary Document	Uploaded 2020-05-20	Repair queued
Citation of § 20.2106.docx	Supplementary Document	Uploaded 2020-05-20	Repair queued
SORN NIST-5.docx	Supplementary Document	Uploaded 2020-05-20	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
241904	Form NIST-366A: Request for Personal Radiation Monitoring Services	Form	Modified	Request for Personal Radiation Monitoring Services
241904	Form NIST-366A: Request for Personal Radiation Monitoring Services	Form	Modified

ICR Details

OMB Control No: 0693-0086	ICR Reference No: 202306-0693-001
Status: Active	Previous ICR Reference No: 202005-0693-001
Agency/Subagency: DOC/NIST	Agency Tracking No: MO
Title: Form NIST-366A: Request for Personal Radiation Monitoring Services
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/21/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/28/2023
Terms of Clearance: This collection is approved based on the revised materials provided by the Department.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2026	36 Months From Approved	08/31/2023
Responses	600	0	600
Time Burden (Hours)	150	0	150
Cost Burden (Dollars)	0	0	0

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Abstract: The National Institute of Standards and Technology (NIST) is required by 10 CFR 20.1502 and CFR 20.2106 to monitor individuals who may be exposed to ionizing radiation above specific levels. This form will be used to collect information associated with this monitoring and to determine the type of monitoring required. NIST conducts research on materials, physics, biology, chemistry and other scientific disciplines using radiation sources. Individuals may be exposed to this radiation when conducting their research or as part of support services provided at NIST.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 19925	04/04/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 41596	06/27/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Form NIST-366A: Request for Personal Radiation Monitoring Services	NIST-366A	Request for Personal Radiation Monitoring Services

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	600	600	0	0	0	0
Annual Time Burden (Hours)	150	150	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $500

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/28/2023

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