Chronic Beryllium Disease Prevention Program

OMB 1910-5112

DOE and DOE contractors will use this information collecton to manage chronic beryllium disease prevention programs, provide information to employees, and facilitate DOE ovesight of the programs.

The latest form for Chronic Beryllium Disease Prevention Program expires 2021-04-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form DOE F 440.1 Signed Consent Forms for Medical Exams Form and Instruction
OMB 1910-5112 Supporting Statement Final 2021.docx Supporting Statement A
OMB 1910-5112 Beryllium 10 CFR-850.pdf Supplementary Document
OMB 1910-5112 30 Day Federal Register Notice FRN Published 4-7-2021.pdf Supplementary Document
OMB 1910 5112 60 Day Federal Register Notice FRN Published 1-4-2021.pdf Supplementary Document
Maintain Beryllium Registry
Annual Performance Feedback
Annual Recordkeeping
Signed Consent Forms for Medical Exams Form and Instruction
Worker Notification of Monitoring Results
Annual Revisions to CBDPP Plans

OMB Details

Annual Revisions to CBDPP Plans

Federal Enterprise Architecture: Health - Public Health Monitoring

202104-1910-001 Approved with change	Revision of a currently approved collection	2021-04-30
201712-1910-002 Approved with change	Revision of a currently approved collection	2017-12-28
201212-1910-002 Approved with change	Revision of a currently approved collection	2012-12-27
200909-1910-001 Approved with change	Revision of a currently approved collection	2009-09-30
200609-1910-002 Approved with change	Revision of a currently approved collection	2006-09-15
200306-1910-001 Approved without change	Reinstatement without change of a previously approved collection	2003-06-24
200002-1910-001 Approved without change	New collection (Request for a new OMB Control Number)	2000-02-17