Information Collection

Lower Duwamish Waterway Superfund Site ICIAP "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms

IC 268119 under ICR 202404-2030-001 · OMB 2030-0051.

Documents and Forms

Document Name Document Type
Form 6700-021 Lower Duwamish Waterway Superfund Site ICIAP "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms Form
6700-021 CHA Behavior Survey CHA_BehaviorSurvey.pdf Form
6700-021 CHA Behavior Survey CHA_BehaviorSurvey.pdf Form
6700-022 Pre-Assessment of CHAs-in-Training PREcurric_Final.pdf Form
6700-022 Pre-Assessment of CHAs-in-Training PREcurric_Final.pdf Form
6700-023 Post-Assessment of CHAs-in-Training POSTcurric_FINAL.pdf Form
6700-023 Post-Assessment of CHAs-in-Training POSTcurric_FINAL.pdf Form
6700-026 Fishers Workshop Background Survey FishersWG_BackgroundSurvey.pdf Form
6700-026 Fishers Workshop Background Survey FishersWG_BackgroundSurvey.pdf Form
6700-018 Fishers Workshop PRE-Survey FishersWG_PreSurvey.pdf Form
6700-018 Fishers Workshop PRE-Survey FishersWG_PreSurvey.pdf Form
6700-019 Fishers Workshop POST-Survey FishersWG_PostSurvey.pdf Form
6700-019 Fishers Workshop POST-Survey FishersWG_PostSurvey.pdf Form
6700-020 Fishers Workshop Pledges FishersWG_Pledges.pdf Form
6700-020 Fishers Workshop Pledges FishersWG_Pledges.pdf Form
6700-017 Moms and Caregivers Background Survey MomsWG_BackgroundSurvey.pdf Form
6700-017 Moms and Caregivers Background Survey MomsWG_BackgroundSurvey.pdf Form
6700-016 Moms and Caregivers Mini Quiz MomsWG_MiniQuiz.pdf Form
6700-016 Moms and Caregivers Mini Quiz MomsWG_MiniQuiz.pdf Form
6700-015 Moms and Caregivers Pledges MomsWG_Pledges.pdf Form
6700-015 Moms and Caregivers Pledges MomsWG_Pledges.pdf Form
6700-014 Moms and Caregivers Self-Assessment MomsWG_SelfAssessment.pdf Form
6700-014 Moms and Caregivers Self-Assessment MomsWG_SelfAssessment.pdf Form
6700-013 Outreach Event Survey OutreachEventSurvey.pdf Form
6700-013 Outreach Event Survey OutreachEventSurvey.pdf Form
Justification_R10_Lower Duwamish Waterway ICIAP Program.docx Justification IC Document
Justification_R10_Lower Duwamish Waterway ICIAP Program.docx Justification IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Lower Duwamish Waterway Superfund Site ICIAP "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms	Agency IC Tracking Number:	2434.266

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	6700-021	CHA Behavior Survey	CHA_BehaviorSurvey.pdf	Yes	Yes	Fillable Printable
Form	6700-022	Pre-Assessment of CHAs-in-Training	PREcurric_Final.pdf	Yes	Yes	Fillable Printable
Form	6700-023	Post-Assessment of CHAs-in-Training	POSTcurric_FINAL.pdf	Yes	Yes	Fillable Printable
Form	6700-026	Fishers Workshop Background Survey	FishersWG_BackgroundSurvey.pdf	Yes	Yes	Fillable Printable
Form	6700-018	Fishers Workshop PRE-Survey	FishersWG_PreSurvey.pdf	Yes	Yes	Fillable Printable
Form	6700-019	Fishers Workshop POST-Survey	FishersWG_PostSurvey.pdf	Yes	Yes	Fillable Printable
Form	6700-020	Fishers Workshop Pledges	FishersWG_Pledges.pdf	Yes	Yes	Fillable Printable
Form	6700-017	Moms and Caregivers Background Survey	MomsWG_BackgroundSurvey.pdf	Yes	Yes	Fillable Printable
Form	6700-016	Moms and Caregivers Mini Quiz	MomsWG_MiniQuiz.pdf	Yes	Yes	Fillable Printable
Form	6700-015	Moms and Caregivers Pledges	MomsWG_Pledges.pdf	Yes	Yes	Fillable Printable
Form	6700-014	Moms and Caregivers Self-Assessment	MomsWG_SelfAssessment.pdf	Yes	Yes	Fillable Printable
Form	6700-013	Outreach Event Survey	OutreachEventSurvey.pdf	Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Environmental Management

Subfunction: Environmental Remediation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 675	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	675	675
Annual IC Time Burden (Hours)	323	323
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification	Justification_R10_Lower Duwamish Waterway ICIAP Program.docx	05/30/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.