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Respiratory Assessment Form - Spirometry Facility Employee

IC 212086 under ICR 202507-0920-012 · OMB 0920-0020.

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Respiratory Assessment Form - Spirometry Facility Employee 0920-0020-24IK
 
No Unchanged
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CDC/NIOSH 2.13 (E), rev 04/2016 Respiratory Assessment Form Attachment 16.docx Yes Yes Fillable Fileable
Form 0920-24IK Respiratory Assessment Form Attachment 16_Respiratory-Assessment-Form (2.13).pdf Yes Yes Fillable Fileable

Health Illness Prevention

Mortality Studies in Coal Mining, Metal and Non-Metal Mining and General Industry – 09-20-0153  51 FR 42478

619 0
   
Individuals or Households
 
   50 %

  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 619 0 0 0 0 619
Annual IC Time Burden (Hours) 52 0 0 0 0 52
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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