OMB control number

Collections Related to Synthetic Turf Fields with Crumb Rubber Infill

OMB 0923-0054 · HHS/TSDR.

OMB 0923-0054

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Activity 2 - Exposure Measurement Form (Youth/Child Facility Users	Form and Instruction
Activity 2 - Phlebotomist Safety Exclusion Questions Form (Parents/Guardians of Youth/Child Facility Users)	Form and Instruction
Activity 2 - Youth and Child Questionnaire - (Parents/Guardians of Youth/Child Facility Users)	Form and Instruction
Activity 2 - Eligibility Screening Script (Parents/Guardians of Youth/Child Facility Users)	Form and Instruction
Activity 2 - Phlebotomist Safety Exclusion Questions Form - (Adult/Adolescent Facility Users)	Form and Instruction
Activity 2 - Exposure Measurement Form - (Adult/Adolescent Facility Users)	Form and Instruction
Activity 2 - Adult and Adolescent Questionnaire (Adult/Adolescent Facility Users)	Form and Instruction
Activity 2 - Eligibility Screening Script (Adult/Adolescent Facility Users)	Form and Instruction
Activity 1 - Field Sampling Collection Form	Form and Instruction
Activity 1 - Owner Manager Questionnaire	Form and Instruction
Activity 1 - Eligibility Screening Form	Form and Instruction
Activity 1 - Facility Sampling Collection Form	Form and Instruction
Activity 1 - Invitation Telephone Script	Form and Instruction
Att7 Synthetic Turf Research Protocol_20160801_Clean.docx	Supplementary Document
Change Request Justification - 0923-0054 Synthetic Turf 20160811.docx	Justification for No Material/Nonsubstantive Change
Att5c Activity 2 ConsentAssentPermissionForms_Clean 8.1.16.docx	Supplementary Document
Att5a Field User Fact Sheet_20160801_Clean.docx	Supplementary Document
Att4g SynTurfFldFacilSmpleCollctnAgrmntForm_20160801_Clean.docx	Supplementary Document
Att4e Synthetic Turf Field Facility Fact Sheet_20160801_Clean.docx	Supplementary Document
Att4c TireRecyclngFacil Sample Collctn Agrmnt Form_20160801_Clean.docx	Supplementary Document
Att4a Tire Recycling Plant Fact Sheet_20160801_Clean.docx	Supplementary Document
Att8 CDC IRB Approval 20160729.pdf	Supplementary Document
Change Request Justification - 0923-0054 Synthetic Turf.docx	Justification for No Material/Nonsubstantive Change
Att5c Activity 2 ConsentAssentPermissionForms_20160716 clean.docx	Supplementary Document
Att5a Field User Fact Sheet_20160716 clean.docx	Supplementary Document
Att4g SynTurfFldFacilSmpleCollctnAgrmntForm_20160716 clean.docx	Supplementary Document
Att4e Synthetic Turf Field Facility Fact Sheet_20160716 clean.docx	Supplementary Document
Att4c TireRecyclngFacil Sample Collctn Agrmnt Form_20160718 clean.docx	Supplementary Document
Att4a Tire Recycling Plant Fact Sheet_20160716 clean.docx	Supplementary Document
SSB _Synthetic Turf_20160716 clean.docx	Supporting Statement B
SSA _Synthetic Turf_20160720 clean.docx	Supporting Statement A
Att9 US EPA Human Research Review Approval.pdf	Supplementary Document
Att8 CDC IRB Approval.docx	Supplementary Document
Att7 Research Protocol.docx	Supplementary Document
Att3 ExtrnlPeerReviewCmmnts and AgencyRspnses.docx	Supplementary Document
Att2a Responses to Public Comments.docx	Supplementary Document
Att2a Category 8 - Previous Studies and Literature Review Comments.pdf	Supplementary Document
Att2a Category 7 - Epidemiological study comments.pdf	Supplementary Document
Att2a Category 6 - Methodology Comments.pdf	Supplementary Document
Att2a Category 5 - Detailed Requests.pdf	Supplementary Document
Att2a Category 4 - Banning moratorium and precautionary principle comments.pdf	Supplementary Document
Att2a Category 3 - Beyond the Scope Comments.pdf	Supplementary Document
Att2a Category 2 - Children and Childrens Health Comments.pdf	Supplementary Document
Att2a Category 1 - General Comments.pdf	Supplementary Document
ATSDR 30-Day FRN_Synthetic Turf.docx	Supplementary Document
Att2 60d FRN SynthcTrf Crumb Rubber 20160218.pdf	Supplementary Document
Att1 AuthLegsl.docx	Supplementary Document
20160711 OMBEmerRqustMemo Synthetic Turf 7.11.16_Signed.pdf	Supplementary Document
Activity 2 - Exposure Measurement Form (Youth/Child Facility Users	Form and Instruction
Activity 2 - Phlebotomist Safety Exclusion Questions Form (Parents/Guardians of Youth/Child Facility Users)	Form and Instruction
Activity 2 - Youth and Child Questionnaire - (Parents/Guardians of Youth/Child Facility Users)	Form and Instruction
Activity 2 - Eligibility Screening Script (Parents/Guardians of Youth/Child Facility Users)	Form and Instruction
Activity 2 - Phlebotomist Safety Exclusion Questions Form - (Adult/Adolescent Facility Users)	Form and Instruction
Activity 2 - Exposure Measurement Form - (Adult/Adolescent Facility Users)	Form and Instruction
Activity 2 - Adult and Adolescent Questionnaire (Adult/Adolescent Facility Users)	Form and Instruction
Activity 2 - Eligibility Screening Script (Adult/Adolescent Facility Users)	Form and Instruction
Activity 1 - Field Sampling Collection Form	Form and Instruction
Activity 1 - Owner Manager Questionnaire	Form and Instruction
Activity 1 - Eligibility Screening Form	Form and Instruction
Activity 1 - Facility Sampling Collection Form	Form and Instruction
Activity 1 - Invitation Telephone Script	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
201608-0923-002	No material or nonsubstantive change to a currently approved collection	2016-08-12	Approved without change
201608-0923-001	No material or nonsubstantive change to a currently approved collection	2016-08-04	Approved without change
201607-0923-001	New collection (Request for a new OMB Control Number)	2016-07-21	Approved with change