OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Onsite Consultation Agreements (29 CFR Part 1908) State Projects

IC 14039 under ICR 202505-1218-003 · OMB 1218-0110.

Documents and Forms

Documents and forms in this information collection
Document NameDocument 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)

layout table

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
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


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 53,472 0 0 0 0 53,472
Annual IC Time Burden (Hours) 175,607 0 0 0 0 175,607
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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