Information Collection

[PHIC/NCEH] EPH Practice Repository: Piloting the Collection and Dissemination of Environmental Public Health Practices (2025-2026)

IC 277092 under ICR 202410-0920-015 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
EPH Survey [PHIC/NCEH] EPH Practice Repository: Piloting the Collection and Dissemination of Environmental Public Health Practices (2025-2026)	Form and Instruction
EPH Survey Att_A_EPHSurvey_RC_08212025.pdf	Form and Instruction
Att_C_Invitation_08062025.docx Invitation to Participate	IC Document
Att_D_Survey_Email_08062025.docx Survey Email	IC Document
Att_E_Glossary_08062025.docx Glossary	IC Document
Att_F_Reminder_08062025.docx Reminder Email	IC Document
STARS project determination.pdf Research Determination	IC Document
SSA_EPHPractice_08062026.docx SSA	IC Document
SSB_EPHPractice_08062026.docx SSB	IC Document
Att_B_EPHSurvey_08212025.docx EPH Survey (Word)	IC Document

IC Title:

[PHIC/NCEH] EPH Practice Repository: Piloting the Collection and Dissemination of Environmental Public Health Practices (2025-2026)

Agency IC Tracking Number:

0920-25-0157

IC Status: New

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 and Instruction	n/a				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15

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	15	15
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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