Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Change in MCR per 1625-AB99 New 67 67 0
Employee training documentation Unchanged 69600 4524 0 Instruction
Employer documentation of refusal to provide blood, breath urine specimens for chemical test Unchanged 1 1 0 Instruction
Exemption from foreign laws Unchanged 1 1 0 Instruction
Periodic test result report Unchanged 87000 5655 0 Instruction
Positive chemical test report to OCMI Unchanged 40 10 0 Instruction
Positive drug/alcohol test report to OCMI. Unchanged 40 10 0 Instruction
Post accident determination documentation Unchanged 473 237 0 Instruction
Instruction
Promulgating the policy requirement Unchanged 87 174 0 Instruction
Reasonable suspicion determination documentation Unchanged 79 6 0 Instruction
Refusal-to-test record (from reasonable suspicion) Unchanged 3 1 0 Instruction
Supervisor training documentation. Unchanged 17400 1131 0 Instruction
Written report of marine casualty Modified 4885 9775 0 Form and Instruction CG-2692 (04/18) Report of Marine Casualty, Commercial Diving Casualty, or OCS-Related Casualty
Form and Instruction CG-2692A (03/16) Bargge Addendum
Form and Instruction CG-2692B (04/18) Report of Mandatory Chemical Testing Following a Serious Marine Incident Involving Vessels in Commercial Service
Form and Instruction CG-2692C (03/16) Personnel Casualty Addendum
Form and Instruction CG-2692D (03/16) Involved Persons and Witnesses Addendum
Instruction
Total burden requested under this ICR: 179676 21592 0  
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