Information Collection

Onsite Consultation Agreements (29 CFR Part 1908) State Projects

IC 14039 under ICR 202409-1218-003 · OMB 1218-0110.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0110 can be found here:

2025-05-06 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 33 Safety and Health Program Assessment Worksheet Onsite Consultation Agreements (29 CFR Part 1908) State Projects	Form
OSHA_INSTRUCTION(CPPM)_final_1-18-08.doc	Instruction
OSHA_INSTRUCTION(CPPM)_final_1-18-08.doc	Instruction
PSM Evaluation Worksheet.docx	Other-worksheet
PSM Evaluation Worksheet.docx	Other-worksheet
Apx E Interim-Year SHARP Self-Eval (CPPM doc).docx	Other-worksheet
Apx E Interim-Year SHARP Self-Eval (CPPM doc).docx	Other-worksheet
Apx F-1 SHP Action Plan Template (Apx F - CPPM doc).docx	Other-worksheet
Apx F-1 SHP Action Plan Template (Apx F - CPPM doc).docx	Other-worksheet
Apx F-2 Optional SHP Action Plan Tool (Apx F -CPPM doc).docx	Other-worksheet
Apx F-2 Optional SHP Action Plan Tool (Apx F -CPPM doc).docx	Other-worksheet
Apx L-2 PSM SHARP Self-Eval.docx	Instruction
Apx L-2 PSM SHARP Self-Eval.docx	Instruction
Apx L-3 Determining Applicability of PSM.docx	Instruction
Apx L-3 Determining Applicability of PSM.docx	Instruction
Apx M- Incident Investigation Report_Updated 11-13-24.docx	Other-worksheet
Apx M- Incident Investigation Report_Updated 11-13-24.docx	Other-worksheet
Table C-1 Optional PSM Wksht (for PSM Eval Wksht).docx	Other-worksheet
Table C-1 Optional PSM Wksht (for PSM Eval Wksht).docx	Other-worksheet
Table C-2 Optional PSM Wksht (for PSM Eval Wksht).docx	Other-worksheet
Table C-2 Optional PSM Wksht (for PSM Eval Wksht).docx	Other-worksheet
Table D Optional PSM Wksht (for PSM Eval Wksht).docx	Other-worksheet
Table D Optional PSM Wksht (for PSM Eval Wksht).docx	Other-worksheet
Table E Optional PSM Wksht (for PSM Eval Wksht).docx	Other-worksheet
Table E Optional PSM Wksht (for PSM Eval Wksht).docx	Other-worksheet
Table M Optional PSM Wksht (for PSM Eval Wksht).docx	Other-worksheet
Table M Optional PSM Wksht (for PSM Eval Wksht).docx	Other-worksheet
Form 33 Safety and Health Program Assessment Worksheet Safety and Health Program Assessment Worksheet Form 33 (January 2022) .docx	Form
Form 33 Safety and Health Program Assessment Worksheet Safety and Health Program Assessment Worksheet Form 33 (January 2022) .docx	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Onsite Consultation Agreements (29 CFR Part 1908) State Projects

Agency IC Tracking Number:

1218-0110 (2024)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 1908

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction		Yes	No	Fillable Printable
Form	Form 33	Yes	Yes	Fillable Fileable
Other-worksheet		No		Fillable Printable
Other-worksheet		No		Fillable Printable
Other-worksheet		No		Fillable Printable
Other-worksheet		No		Fillable Printable
Instruction		No		Printable Only
Instruction		No		Printable Only
Other-worksheet		No		Fillable Printable
Other-worksheet		No		Fillable Printable
Other-worksheet		No		Fillable Printable
Other-worksheet		No		Fillable Printable
Other-worksheet		No		Fillable Printable
Other-worksheet		No		Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 53

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	Previously Approved
Annual Number of Responses for this IC	53,472	-16,789	70,261
Annual IC Time Burden (Hours)	175,607	-41,082	216,689
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.

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