Application for Reimbursement to Local Governments for Emergency Response to Hazardous Substance Releases under CERCLA Section 123 (Renewal)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form 9310-1 Application Package for Reimbursement for Local Governments	Form and Instruction	Modified	Available
1425.15_60.pdf	Supplementary Document	Uploaded 2026-10-21	Available
1425.15_ss.docx	Supporting Statement A	Uploaded 2026-10-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
23856	Application for Reimbursement to Local Governments for Emergency Response to Hazardous Substance Releases Under CERCLA section 123 (Renewal)	Form and Instruction	Modified	Application Package for Reimbursement for Local Governments

ICR Details

OMB Control No: 2050-0077	ICR Reference No: 202609-2050-003
Status: Received in OIRA	Previous ICR Reference No: 202308-2050-001
Agency/Subagency: EPA/OLEM	Agency Tracking No: 1425.15
Title: Application for Reimbursement to Local Governments for Emergency Response to Hazardous Substance Releases under CERCLA Section 123 (Renewal)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/29/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	10/31/2026
Responses	15	20
Time Burden (Hours)	131	170
Cost Burden (Dollars)	0	0

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Abstract: Local governments can apply for reimbursement (up to $25,000 per response) for temporary emergency response measures related to the release (or threatened release) of a hazardous substance. The information collected on the Application for Reimbursement to Local Governments for Emergency Response to Hazardous Substance Releases under CERCLA Sec. 123 form is supplied voluntarily by local governments. Since the last ICR renewal, agency costs have increased. While the individual respondent burden hours have slightly increased, the overall respondent burden has decreased due to fewer applications expected annually. Some minor changes were made to the application form as part of this renewal, adding four new pieces of information, and removing three pieces of information.

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Authorizing Statute(s): PL: Pub.L. 99 - 499 123 Name of Law: Superfund Amendments and Reauthorization Act of 1986
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 21809	04/23/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 68138	10/29/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Application for Reimbursement to Local Governments for Emergency Response to Hazardous Substance Releases Under CERCLA section 123 (Renewal)	Form 9310-1	Application Package for Reimbursement for Local Governments

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	15	20	0	0	-5	0
Annual Time Burden (Hours)	131	170	0	0	-39	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The overall respondent burden has decreased due to fewer applications expected annually (down from 20 to 15). However, individual respondent burden for completing the form is estimated to have increased slightly from 8.5 hours to 8.75 hours. The additional response time is a result of some refinements made to the electronic form. Specifically, the updated form includes four new pieces of information (email under 1d and additional dates and ‘Other’ definition under 3b) and eliminates three pieces of previously collected information (time under 2a, time under 3a, and time under 3b). Because the modifications to the form are non-substantive in nature the resulting burden changes are considered to be adjustments.

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Annual Cost to Federal Government: $70,633

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/29/2026

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