Occupational Noise Exposure

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Occupational Noise Exposure	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 62.180(b) 30 CFR 62.190(a) and (b) 30 CFR 62.110(d) 30 CFR 62.130(a) 30 CFR 62.171(b) 30 CFR 62.174(a) 30 CFR 62.172(a)(1) and (a)(2) 30 CFR 62.175(a)(1) and (a)(2)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,530	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	186,252	-10	-3,739	190,001
Annual IC Time Burden (Hours)	14,273	0	120	14,153
Annual IC Cost Burden (Dollars)	127,648	0	97,063	30,585

Documents for IC

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