Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Birth Defects Prevelance Form Unchanged 22 1760 0 Form and Instruction NA Birth Defects Prevelance Form
Childhood Lead Blood Levels Form Unchanged 18 1440 0 Form and Instruction NA Childhood Lead Blood Levels Form
Communications Plan Unchanged 30 600 0 Form and Instruction NA Communications Plan Form
Community Drinking Water Monitoring Form Unchanged 30 3600 0 Form and Instruction NA Community Drinking Water Monitoring Form
Earned Value Management Report Removed 0 0 0 Form and Instruction NA Earned Value Management Report Form
Emergency Department Visits Form Unchanged 26 2080 0 Form and Instruction NA Emergency Department Visits Form
Environmental Public Health Tracking Work Plan Template Modified 52 1560 0 Form and Instruction NA Program Management Tool (New Awardees) Form
Form and Instruction 0920-1175 Environmental Public Health Tracking Work Plan Template
Evaluation and Performance Measurement Strategy Report Unchanged 30 600 0 Form and Instruction NA Evaluation and Measurement Strategy Report Form
Hospitalizations Unchanged 30 2400 0 Form and Instruction NA Hospitalizations Form
Metadata Records Unchanged 180 3600 0 Form and Instruction NA Metadata Records Form
Publilc Health Action Report - Existing Awardees Modified 104 1040 0 Form and Instruction NA Public Health Action Report (Existing Awardees) Form
Radon Testing Unchanged 16 1920 0 Form and Instruction NA Radon Testing Form
Website Analytics Modified 60 60 0 Form and Instruction NA Website Analytics Form
Total burden requested under this ICR: 598 20660 0  
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