Information Collection

PCB Reporting

IC 255773 under ICR 202606-2050-001 · OMB 2050-0230.

Documents and Forms

Document Name Document Type
Form 7720-12 PCB Transformer Registration PCB Reporting Form and Instruction
Form 7710-53 PCB Notification of PCB Activity PCB Reporting Form and Instruction
Form 6200-025 PCB Annual Form PCB Reporting Form and Instruction
2688.03 EPA Form 7720-12 Instructions.pdf Instruction
7720-12 PCB Transformer Registration 2688.03 Form 7720-12.pdf www.epa.gov/sites/default/files/2015-08/doc. Form and Instruction
7710-53 PCB Notification of PCB Activity 2688.03 Form 7710-53.pdf www.epa.gov/sites/default/files/2015-08/doc. Form and Instruction
6200-025 PCB Annual Form 2688.03 Form 6200-025.pdf www.epa.gov/pcbs/pcb-annual-report-form... Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PCB Reporting	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 44 CFR 3501 40 CFR 761

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	7720-12	PCB Transformer Registration	2688.03 Form 7720-12.pdf	https://www.epa.gov/sites/default/files/2015-08/doc.	Yes	Yes	Fillable Fileable Signable
Instruction			2688.03 EPA Form 7720-12 Instructions.pdf		Yes	No	Fillable Fileable
Form and Instruction	7710-53	PCB Notification of PCB Activity	2688.03 Form 7710-53.pdf	https://www.epa.gov/sites/default/files/2015-08/doc.	Yes	Yes	Fillable Fileable Signable
Form and Instruction	6200-025	PCB Annual Form	2688.03 Form 6200-025.pdf	https://www.epa.gov/pcbs/pcb-annual-report-form...	Yes	Yes	Fillable Fileable Signable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 744	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	744	816	-1,157	1,085
Annual IC Time Burden (Hours)	72,576	96,200	-31,900	8,276
Annual IC Cost Burden (Dollars)	5,901	0	4,150	1,751

Documents for IC

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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].