Follow-Up Survey - States

2020 Drinking Water Infrastructure Needs Survey and Assessment (NEW)

Documents and Forms

Document Name Document Type
2616.02 Appendix A - Example Survey Instrument.docx Other-Example Survey Instrument

Information Collection (IC) Details

IC Title:	Follow-Up Survey - States	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320.13

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Example Survey Instrument			2616.02 Appendix A - Example Survey Instrument.docx		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,924	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,924	2,924
Annual IC Time Burden (Hours)	1,374	1,374
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.