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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
NGWA_Intervention to Prevent Exposure to Contaminants in Drinking Water
Agency IC Tracking Number:
15TK
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-WORD
C_Instrument.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
30
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
30
0
30
0
0
0
Annual IC Time Burden (Hours)
30
0
30
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statement A
1 NGWA-EVAL-SSA.docx
03/11/2015
Supporting Statement B
2 NGWA-EVAL-SSB.docx
03/11/2015
Att A_UOI-Online Assessment Results Table
A_Preliminary Results.docx
03/11/2015
Att D_Project Overview
D_Project Overview.docx
03/11/2015
Att E_Invitational Email to Participants
E_Invitation Email.docx
03/11/2015
Att F_Reminder Email
F_Reminder Email.docx
03/11/2015
Att G_Confirmation of In-Person Interview E-mail
G_Confirmation In-person Interview.docx
03/11/2015
Att H_Confirmation of Telephone Interview Email
H_Confirmation Telephone Interview.docx
03/11/2015
Att B_UOI Online Assessment Results (ppp)
B_Results PPT.ppt
03/12/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.