Information Collection

Att 8- Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater (WW) Systems Supporting a Poliovirus- Essential Facility (PEF) in the United States

IC 263170 under ICR 202311-0920-001 · OMB 0920-1424.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1424 can be found here:

2025-11-24 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920 Att 8- Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater (WW) Systems Supporting a Poliovirus- Essential Facility (PEF) in the United States	Form and Instruction
0920 Poliovirus Containment Sampling Points and Sanitation As Att8_Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater_Final.pdf	Form and Instruction
0920 Poliovirus Containment Sampling Points and Sanitation As Att8_Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater_Final.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Att 8- Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater (WW) Systems Supporting a Poliovirus- Essential Facility (PEF) in the United States

Agency IC Tracking Number:

0920-23BJ

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Form and Instruction	0920	Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater (WW) Systems Supporting a Poliovirus- Essential Facility (PEF) in the United States	Att8_Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater_Final.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	30	30
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.