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ASARCO Smelter Exposure Investigation 0923-15BI
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-15BI Att4_ASARCO EI Participant Questionnaire Att4_ASARCO EI Participant Questionnaire_Oct23_2014.docx No   Fillable Printable

Health Public Health Monitoring

 

200 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 200 0 200 0 0 0
Annual IC Time Burden (Hours) 67 0 67 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Asarco Smelter EI_GenIC SubmissionForm_Oct23_2014 Asarco Smelter EI_GenIC SubmissionForm_Oct23_2014.docx 11/03/2014
Att1_ASARCO EI_SupStatement A_Oct23_2014 Att1_ASARCO EI_SupStatement A_Oct23_2014.docx 11/03/2014
Att2_ASARCO EI_SupStatementB_Oct23_2014 Att2_ASARCO EI_SupStatementB_Oct23_2014.docx 11/03/2014
Att3_ASARCO EI_Permission Assent Consent Forms_Oct23_2014 Att3_ASARCO EI_Permission Assent Consent Forms_Oct23_2014.docx 11/03/2014
Att3A_ASARCO EI_Parental Permission_ChildUnder6_Oct23_2014 Att3A_ASARCO EI_Parental Permission_ChildUnder6_Oct23_2014.docx 11/03/2014
Att3B_ASARCO EI_ParentalPermission_ChildUnder18_Oct23_2014 Att3B_ASARCO EI_ParentalPermission_ChildUnder18_Oct23_2014.docx 11/03/2014
Att3C_ASARCO EI_AssentFormChild7to18_Oct23_2014 Att3C_ASARCO EI_AssentFormChild7to18_Oct23_2014.docx 11/03/2014
Att5_ASARCO EI Research Determination Form_Oct23_2014 Att5_ASARCO EI Research Determination Form_Oct23_2014.pdf 11/03/2014
Att6_ASARCO EI Results Letter Templates Factsheets_Oct23_2014 Att6_ASARCO EI Results Letter Templates Factsheets_Oct23_2014.docx 11/03/2014
Att6A_ASARCO EI_Letter_ChildUnder6_Oct23_2014 Att6A_ASARCO EI_Letter_ChildUnder6_Oct23_2014.docx 11/03/2014
Att6B_ASARCO EI_Letter_Child6to18_Oct23_2014 Att6B_ASARCO EI_Letter_Child6to18_Oct23_2014.docx 11/03/2014
Att6C_ASARCO EI_Letter_PregnantWoman_Oct23_2014 Att6C_ASARCO EI_Letter_PregnantWoman_Oct23_2014.docx 11/03/2014
Att6D_ASARCO EI_Letter Results Inserts_Oct23_2014 Att6D_ASARCO EI_Letter Results Inserts_Oct23_2014.docx 11/03/2014
Att6E_ASARCO EI_Factsheets for Letters_Oct23_2014 Att6E_ASARCO EI_Factsheets for Letters_Oct23_2014.docx 11/03/2014
Att7_Example of Prior Exposure Investigation Final Report_Oct23_2014 Att7_Example of Prior Exposure Investigation Final Report_Oct23_2014.pdf 11/03/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.