Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Coal Miner Radiograph (CWHSP) Modified 14560 3640 0 Instruction
Instruction
Chest Radiograph Classification (CDC/NIOSH Form 2.8) Modified 30140 1507 0 Form 2.8
Coal Contractor Plan CDC/NIOSH 2.18 Modified 575 288 0 Form 2.18
Coal Mine Operator's Plan (CDC/NOISH (M) 2.10) Modified 388 194 0 Form 2.10
Consent Release and History Form- Next of Kin (CDC/NIOSH 2.6) Modified 5 1 0 Form 2.6
Invoice-Pathologist Modified 5 0 0 Instruction
Miner Identification Document (CDC/NIOSH 2.9) Modified 14560 4853 0 Form 2.9
Physician Application for Certification (CDC/NIOSH 2.12) Modified 100 17 0 Form 2.12
Radiographic Facility Certification (CDC/NIOSH (M) 2.11) Modified 40 20 0 Form 2.11
Report - Pathologist Modified 5 0 0 Instruction
Spirometry Facility Employee - Notification form 2.16 Removed 0 0 0 Form 2.16
Spirometry Facility Employee - Respiratory Assessment 2.13 Modified 14560 1213 0 Form 2.13
Spirometry Facility Supervisor - Certification Document 2.14 Modified 100 50 0 Form 2.14
Spirometry Results Notification CDC/NIOSH 2.15 Modified 14560 4853 0 Form 2.15
Spirometry Technician - Results Form 2.17 Removed 0 0 0 Form 2.17
Spirometry Test for Coal Miners Modified 14560 3640 0 Instruction
Total burden requested under this ICR: 104158 20276 0  
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