Information Collection

Questionnaire for the Publicly Owned Treatment Works (POTW) Influent Per- and Polyfluoroalkyl Substances (PFAS) Study and National Sewage Sludge Survey (NSSS)

IC 271508 under ICR 202410-2040-006 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Questionnaire for the Publicly Owned Treatment Works (POTW) Influent Per- and Polyfluoroalkyl Substances (PFAS) Study and National Sewage Sludge Survey (NSSS)	Form and Instruction
QUESTIONNAIRE FOR THE PUBLICLY OWNED TREATMENT WORK 2799.01 POTW Influent PFAS Study and NSSS Questionnaire.docx Qualtrics repository	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Questionnaire for the Publicly Owned Treatment Works (POTW) Influent Per- and Polyfluoroalkyl Substances (PFAS) Study and National Sewage Sludge Survey (NSSS)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 403 40 CFR 503

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	QUESTIONNAIRE FOR THE PUBLICLY OWNED TREATMENT WORK	2799.01 POTW Influent PFAS Study and NSSS Questionnaire.docx	Qualtrics repository	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

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
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	9,240	9,240
Annual IC Cost Burden (Dollars)	1,120	1,120

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.