Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Birth Defects Prevelance Form Modified 22 1760 0 Form and Instruction none Birth Defects Prevalence
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
Emergency Department Visits Form Modified 26 2080 0 Form and Instruction none Emergency Department Visits
Environmental Public Health Tracking Work Plan Template Modified 52 1144 0 Form and Instruction NA Program Management Tool (New Awardees) Form
Form and Instruction none 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 Modified 30 2400 0 Form and Instruction none Hospitalizations
Metadata Records Modified 180 3600 0 Form and Instruction none Metadata Records
Publilc Health Action Report - Existing Awardees Unchanged 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 Unchanged 60 60 0 Form and Instruction NA Website Analytics Form
Total burden requested under this ICR: 598 20244 0  
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