Information Collection

RadNet - Drinking Water

IC 178892 under ICR 202403-2060-001 · OMB 2060-0015.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5900-23 RadNet - Drinking Water	Form
5900-23 RadNet Supply Request Form Form 5900-23 - RadNet Supply Request Form.pdf	Form
5900-29 RadNet Drinking Water Report Form 5900-29 - RadNet Drinking Water Report Form.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	5900-23	RadNet Supply Request Form	Form 5900-23 - RadNet Supply Request Form.pdf		No		Paper Only
Form	5900-29	RadNet Drinking Water Report	Form 5900-29 - RadNet Drinking Water Report Form.pdf		No		Paper Only

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 47

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	188	-84	272
Annual IC Time Burden (Hours)	116	-52	168
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.