Office of Marine & Aviation Operations: Occupational Health, Safety, and Readiness Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form NF 57-10-02 Annual Tuberculosis Screening Document	Form and Instruction	New	Available
Form NF 57-10-02 Tuberculosis Screening Document	Form and Instruction	New	Repair queued
Form NF 57-10-01 NOAA Health Services Questionnaire	Form and Instruction	New	Available
Form NF 57-10-01 NOAA Health Services Questionnaire (NHSQ)	Form and Instruction	New	Repair queued
0648-OMAO 30-day 89 FR 5209 2024-0126.pdf	Supplementary Document	Uploaded 2024-01-26	Repair queued
0648-OMAO Supporting Statement Part A.docx	Supporting Statement A	Uploaded 2024-01-19	Repair queued
NOAA Policy 1008 - Tuberculosis Policy.pdf	Supplementary Document	Uploaded 2024-01-19	Repair queued
USCODE 33-chap18-sec941.pdf	Supplementary Document	Uploaded 2024-01-17	Repair queued
OMAO 1006 - Immunizations, Communicable Disease Protection, and Chemoprophylaxis.docx	Supplementary Document	Uploaded 2024-01-17	Repair queued
0648-OMAO 60-day 88 FR 56009 2023-0817.pdf	Supplementary Document	Uploaded 2024-01-17	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
264469	Tuberculosis Screening Document	Form and Instruction	New	Annual Tuberculosis Screening Document
264469	Tuberculosis Screening Document	Form and Instruction	New
264468	NOAA Health Services Questionnaire (NHSQ)	Form and Instruction	New	NOAA Health Services Questionnaire
264468	NOAA Health Services Questionnaire (NHSQ)	Form and Instruction	New

ICR Details

OMB Control No: 0648-0824	ICR Reference No: 202401-0648-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOC/NOAA	Agency Tracking No: 0648-OMAO
Title: Office of Marine & Aviation Operations: Occupational Health, Safety, and Readiness Forms
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/26/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/26/2024
Terms of Clearance: Before the next renewal NOAA must proactively seek feedback from at least 4 people outside the organization (not including comments received during the 60-day comment period). The feedback must address burden, clarity and utility of the forms in this collection.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2027	36 Months From Approved
Responses	1,000	0	0
Time Burden (Hours)	167	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This is a request for approval of a collection currently in use without OMB approval. The National Oceanic and Atmospheric Administration's (NOAA) Office of Marine and Aviation Operations (OMAO) manages and operates NOAA's fleet of 15 research and survey ships and nine specialized environmental data-collecting aircraft. Comprised of civilians and officers of the NOAA Commissioned Officer Corps, OMAO also manages the NOAA Diving Program, NOAA Small Boat Program, and NOAA Uncrewed Systems Operations Center. The research and survey ships operated, managed, and maintained by OMAO comprise the largest fleet of federal research ships in the nation. Ranging from large oceanographic research vessels capable of exploring the world’s deepest ocean, to smaller ships responsible for charting the shallow bays and inlets of the United States, the fleet supports a wide range of marine activities including fisheries surveys, nautical charting, and ocean and climate studies. This collection covers the forms that are required to make medical readiness recommendations.

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Authorizing Statute(s): US Code: 33 USC 941 Name of Law: Navigation and Navigable Waters
  

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 56009	08/17/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 5209	01/26/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
NOAA Health Services Questionnaire (NHSQ)	NF 57-10-01	NOAA Health Services Questionnaire
Tuberculosis Screening Document	NF 57-10-02	Annual Tuberculosis Screening Document

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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	1,000	0	0	1,000	0	0
Annual Time Burden (Hours)	167	0	0	167	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new collection of information.

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Annual Cost to Federal Government: $520,966

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: 01/26/2024

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