ICR Documents

Supporting Statement A Document Date Uploaded SSA Private Wells CLEAN 3-9-17 CLEAN 20201230.docx 01/04/2021 Supporting Statement B Document Date Uploaded 1 - SSB Private Wells Ext_20200303 clean.docx 03/12/2020 Supplementary Documents Title Document Document Type Date Uploaded Authorizing legislation AttA_Public Health Service Act Section 301 20200303.docx Supplementary Document 03/12/2020 60 day FRN AttB 60-day FRN Private Well 20190917.pdf Supplementary Document 03/12/2020 Instructions for genIC AttC Instructions Generic ICR 20200303.docx Supplementary Document 03/12/2020 genIC Request Form AttD Request Approval Generic ICR 20200303.docx Supplementary Document 03/12/2020 PIA AttE Privacy Impact Assessment_signed_CSPO_20200225.pdf Supplementary Document 03/12/2020 Example recruitment letter AttF Example Recruiting Flyer Letter 20200303.docx Supplementary Document 03/12/2020 Example screener AttG Example Screening Form 20200303.docx Supplementary Document 03/12/2020 Example consent AttH Example Consent Form 20200303.docx Supplementary Document 03/12/2020 Example questionnaire AttH Example Questionnaire 3-8-17 CLEAN 20001230.docx Supplementary Document 01/04/2021 Instructions for specimen collection AttJ Instructions for Urine and Water 20200303.docx Supplementary Document 03/12/2020 Research determination AttK Research Determination Form 20170313.pdf Supplementary Document 03/12/2020 Burden memo documentation Attl Private Well Burden Memo 20200303.docx Supplementary Document 03/12/2020 Public comments and response AttB1 PblcCommnts Agncy Respnse 20200303.pdf Supplementary Document 03/16/2020 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received