Information Collection

Follow-Up Survey - CWSs

IC 261928 under ICR 202308-2040-003 · OMB 2040-0302.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2616.02 Appendix A - Example Survey Instrument.docx	Other-Example Survey Instrument
2616.02 Appendix A - Example Survey Instrument.docx	Other-Example Survey Instrument

IC Title:

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:

table that charts list of 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: 3,629

Number of Respondents for Small Entity: 606

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,629	3,629
Annual IC Time Burden (Hours)	1,745	1,745
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.