Information Collection

Healthcare Wastewater-based Surveillance - Annual Evaluation and Performance Measurement Report

IC 271460 under ICR 202409-0920-016 · OMB 0920-1310.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1310 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form I18 Healthcare Wastewater-based Surveillance - Annual Evaluation and Performance Measurement Report	Form and Instruction
I18 Healthcare Wasterwater-based Surveillance Attachment 2r_I.18- HEALTHCARE WASTEWATER-BASED SURVEILLANCE - AEPMR.docx	Form and Instruction
I18 Healthcare Wasterwater-based Surveillance Attachment 2r_I.18- HEALTHCARE WASTEWATER-BASED SURVEILLANCE - AEPMR.docx	Form and Instruction

IC Title:

Healthcare Wastewater-based Surveillance - Annual Evaluation and Performance Measurement Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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 and Instruction	I18	Healthcare Wasterwater-based Surveillance	Attachment 2r_I.18- HEALTHCARE WASTEWATER-BASED SURVEILLANCE - AEPMR.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	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.