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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Coal Miner Radiograph (CWHSP)
Unchanged
14560
3640
0
Instruction
Instruction
Chest Radiograph Classification (CDC/NIOSH Form 2.8)
Modified
30140
1507
0
Form
2.8
Chest Radiograph Classification
Form
0920-0020
Chest Radiograph Classification Form M 2.8 25MAR2019
Coal Contractor Plan CDC/NIOSH 2.18
Unchanged
575
288
0
Form
2.18
Coal Contractor Plan
Coal Mine Operator's Plan (CDC/NOISH (M) 2.10)
Unchanged
388
194
0
Form
2.10
Coal Mine Operator's Plan
Consent Release and History Form- Next of Kin (CDC/NIOSH 2.6)
Unchanged
1
0
0
Form
2.6
Consent, Release and History Form for Autopsy
Invoice-Pathologist
Unchanged
1
0
0
Instruction
Miner Identification Document (CDC/NIOSH 2.9)
Modified
14560
4854
0
Form
2.9
Miner Identification Document
Form
2.9
Miner Identificaiton Document
Form
0920-0020
Miner Identification Document Form M 2.9 25MAR2019
Physician Application for Certification (CDC/NIOSH 2.12)
Modified
80
13
0
Form
2.12
Physician Application for Certification
Form
0920-0020
Physician Application for Certification Form 2.12 25MAR2019
Radiographic Facility Certification (CDC/NIOSH (M) 2.11)
Unchanged
40
20
0
Form
2.11
Radiographic Facility Certification
Report - Pathologist
Unchanged
1
0
0
Instruction
Spirometry Facility Employee - Respiratory Assessment 2.13
Unchanged
14560
1214
0
Form
2.13
Respiratory Assessment
Spirometry Facility Supervisor - Certification Document 2.14
Unchanged
100
50
0
Form
2.14
Spirometry Facility Certification
Spirometry Results Notification CDC/NIOSH 2.15
Unchanged
14560
4854
0
Form
2.15
Spirometry Results Notification form edit
Spirometry Test for Coal Miners
Unchanged
14560
3640
0
Instruction
Total burden requested under this ICR:
104126
20274
0
To view an IC, click on IC Title