Information Collection

Methylene Chloride (1910.1052)

IC 248297 under ICR 202410-1218-002 · OMB 1218-0179.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 29 CFR 1910.1052 Methylene Chloride (1910.1052)	Form and Instruction
Form 29 CFR 1910.1052 Questionnaire for Methylene Chloride Methylene Chloride (1910.1052)	Form and Instruction
App B - Medical Surveillance for Methylene Chloride OSHA.pdf www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1052AppB	Other-Appendix B
App B - Medical Surveillance for Methylene Chloride OSHA.pdf www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1052AppB	Other-Appendix B
29 CFR 1910.1052 Questionnaire for Methylene Chloride Methylene Chloride Appendix B Public Burden Statement _Form 11-01-2024.docx www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1052AppB	Form and Instruction
29 CFR 1910.1052 Questionnaire for Methylene Chloride Methylene Chloride Appendix B Public Burden Statement _Form 11-01-2024.docx www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1052AppB	Form and Instruction

IC Title:

Agency IC Tracking Number:

1218-0179(2024)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1926.1052 29 CFR 1915.1052 29 CFR 1910.1052

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	29 CFR 1910.1052			https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1052AppB	Yes	No	Printable Only
Other-Appendix B				https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1052AppB	Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 89,760

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 15 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	32,437	1,867	30,570
Annual IC Time Burden (Hours)	2,703	155	2,548
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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