Information Collection

Component 2 - STLT and Wastewater Utility Staff

IC 263101 under ICR 202609-0920-006 · OMB 0920-1422.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
10_Attachment 07_Component_1_2_NWSS_DCIPHER_BulkUploadTool_screenshot_NEW.pdf	Other-Template
12_Attachment-09_Component-2_NWSS_DCIPHER_Sewershed_Name_Crosswalk_CSV_Upload_Template_NEW.xlsx	Other-Template
OMB Control Header and Burden Statement_2.docx OMB Control Header and Burden Statement	IC Document

IC Title:

Agency IC Tracking Number:

0920-26-0113

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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
Other-Template					Yes	Yes	Fillable Fileable
Other-Template					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 213

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	213	-887	1,100
Annual IC Time Burden (Hours)	550	-1,650	2,200
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Control Header and Burden Statement		09/28/2026

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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