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Agenda
Reg Review
ICR
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
0920-1175
Birth Defects Prevalence
Childhood Lead Blood Levels Form
Modified
18
1440
0
Form and Instruction
0920-1175
Childhood Lead Blood Levels Form
Communications Plan
Modified
30
600
0
Form and Instruction
none
Communications Plan Form
Community Drinking Water Monitoring Form
Modified
30
3000
0
Form and Instruction
0920-1175
Community Drinking Water Monitoring Form
Emergency Department Visits Form
Modified
30
2400
0
Form and Instruction
0920-1175
Emergency Department Visits
Environmental Public Health Tracking Work Plan Template
Modified
30
1200
0
Form and Instruction
none
Environmental Public Health Tracking Work Plan Template
Hospitalizations
Modified
30
2400
0
Form and Instruction
0920-1175
Hospitalizations
Metadata Records
Modified
180
3600
0
Form and Instruction
0920-1175
Metadata Records
Performance Measurement Strategy Report
New
30
600
0
Form and Instruction
none
Performance Measurement Strategy Report
Publilc Health Action Report - Existing Awardees
Modified
120
2400
0
Form and Instruction
none
Public Health Action Report (Existing Awardees) Form
Radon Testing
Modified
18
1800
0
Form and Instruction
0920-1175
Radon Testing Form
Tracking Program Grantee Partnership Plan Template Instructions
Modified
30
600
0
Form and Instruction
none
Tracking Program Grantee Partnership Plan
Website Analytics
Modified
60
60
0
Form and Instruction
none
Website Analytics Form
Total burden requested under this ICR:
628
21860
0
To view an IC, click on IC Title