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Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Undetermined Source of an outbreak of Legionnaires' Disease among Hotel A Visitors - Hannibal, MO 2015
Agency IC Tracking Number:
0920-1011
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
Form and Instruction
NA
Legionella Environmental Assessment Form
Appendix 1 w coverpage.pdf
NA
No
Paper Only
Form
NA
Sample Data Sheet
Appendix 2 w coverpage.pdf
NA
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
Epidemic Investigation Case Records - 09-20-0113
FR Citation:
51 FR 42466
Number of Respondents:
12
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
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
12
0
12
0
0
0
Annual IC Time Burden (Hours)
18
0
18
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
GenIC Request Legionalla_MO 2015
2016004-XXX LD_MO.docx
11/07/2015
Burden Memo Email Legionella_MO 2015
GenIC Burden Hour Memo Email Legionella_MO 2015.msg
11/07/2015
Letter of Invitation Legionella_MO 2015
MissouriEpiAid_2015 Formal Invitation Letter.docx
11/07/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.