ICR Documents

Supporting Statement A Document Date Uploaded SSA Private Wells 3-17-17 CLEAN.docx 03/30/2017 Supporting Statement B Document Date Uploaded SSB Private Wells 3-17-17 CLEAN.docx 03/30/2017 Supplementary Documents Title Document Document Type Date Uploaded Authorizing Legislation AttA_Public Health Service Act Section 301 3-2-16.docx Supplementary Document 06/09/2016 60 Day FRN - published AttB 60-day FRN 20160311.pdf Supplementary Document 06/09/2016 Public Comments / Agency Response AttB1 PblcCommnts Agncy Respnse 6-1-16.docx Supplementary Document 06/09/2016 Instructions for use of Generic Clearance AttC Instructions Generic Clearance 6-1-16.docx Supplementary Document 06/09/2016 GenIC Request Template AttD Request Approval Generic ICR 6-1-16.docx Supplementary Document 06/09/2016 Example Recruitment Flyer AttE Example Recruiting Flyer Letter 6-1-16.doc Supplementary Document 06/22/2016 Example Screening Form AttF Example Screening Form Clean 6-1-16.docx Supplementary Document 06/22/2016 Example Consent Form AttG Example Consent Form 6-1-16.docx Supplementary Document 06/22/2016 Example Questionnaire AttH Example Questionnaire 6-1-16.docx Supplementary Document 06/22/2016 Example Instructions for Urine and Water Collection AttI Example Instructions for Urine and Water CLEAN 3-3-16.docx Supplementary Document 06/22/2016 Research Determination AttJ Research Determination Form 6-1-16.pdf Supplementary Document 06/22/2016 Burden Memo AttK Private Wells Burden Memo 6-1-16.docx Supplementary Document 06/22/2016 Public Comments / Agency Response 30MAR2017 AttB1 PblcCommnts Agncy Respnse 3-17-17 CLEAN.docx Supplementary Document 03/30/2017 Instructions for use of Generic Clearance 30MAR2017 AttC Instructions Generic ICR 3-17-17 CLEAN.docx Supplementary Document 03/30/2017 Privacy Impact Assessment 30MAR2017 AttE Privacy Impact Assessment 3-17-17 CLEAN.docx Supplementary Document 03/30/2017 Example Recruiting Flyer 30MAR2017 AttF Example Recruiting Flyer Letter 3-17-17 CLEAN.docx Supplementary Document 03/30/2017 Example Screening Form 30MAR2017 AttG Example Screening Form 3-17-17 CLEAN.docx Supplementary Document 03/30/2017 Example Consent Form 30MAR2017 AttH Example Consent Form 3-17-17 CLEAN.docx Supplementary Document 03/30/2017 Example Questionnaire 30MAR2017 AttI Example Questionnaire 3-17-17 CLEAN.docx Supplementary Document 03/30/2017 Example Instructions for Urine and Water Collection 30MAR2017 AttJ Example Instructions for Urine and Water 3-17-16 CLEAN.docx Supplementary Document 03/30/2017 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received