Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Birth Defects Prevelance Form New 22 1760 0 Form and Instruction NA Birth Defects Prevelance Form
Childhood Lead Blood Levels Form New 18 1440 0 Form and Instruction NA Childhood Lead Blood Levels Form
Communications Plan New 30 600 0 Form and Instruction NA Communications Plan Form
Community Drinking Water Monitoring Form New 30 3600 0 Form and Instruction NA Community Drinking Water Monitoring Form
Earned Value Management Report New 120 4800 0 Form and Instruction NA Earned Value Management Report Form
Emergency Department Visits Form New 26 2080 0 Form and Instruction NA Emergency Department Visits Form
Evaluation and Performance Measurement Strategy Report New 30 600 0 Form and Instruction NA Evaluation and Measurement Strategy Report Form
Hospitalizations New 30 2400 0 Form and Instruction NA Hospitalizations Form
Metadata Records New 180 3600 0 Form and Instruction NA Metadata Records Form
Program Management Tool - New Awardees New 104 2080 0 Form and Instruction NA Program Management Tool (New Awardees) Form
Publilc Health Action Report - Existing Awardees New 16 320 0 Form and Instruction NA Public Health Action Report (Existing Awardees) Form
Radon Testing New 16 1920 0 Form and Instruction NA Radon Testing Form
Website Analytics New 120 120 0 Form and Instruction NA Website Analytics Form
Total burden requested under this ICR: 742 25320 0  
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