Information Collection

Att 7c_Site audits,Site audits (completed for each corrective action)

IC 263230 under ICR 202311-0920-004 · OMB 0920-0109.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0109 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0109 Att 7c_Site audits,Site audits (completed for each corrective action)	Form
Form 0920-0109 NIOSH CORRECTIVE ACTION REQUEST (CAR) Form Att 7c_Site audits,Site audits (completed for each corrective action)	Form
0920-0109 NIOSH CORRECTIVE ACTION REQUEST (CAR) Form Atch_7c_Corrective Action Request (CAR) Form.docx	Form
0920-0109 NIOSH CORRECTIVE ACTION REQUEST (CAR) Form Atch_7c_Corrective Action Request (CAR) Form.docx	Form

IC Title:

Att 7c_Site audits,Site audits (completed for each corrective action)

Agency IC Tracking Number:

0920-0109

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 84

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	0920-0109			NA	No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 70

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	140	55	85
Annual IC Time Burden (Hours)	2,240	2,227	13
Annual IC Cost Burden (Dollars)	0	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.

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