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View Information Collection (IC)

View Information Collection (IC)

Blood Lead and Urine Arsenic Levels in Anaconda, MT - Exposure Investigation: Anaconda EI II 0923-0048-19BV
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0923-0048 NA Yes Yes Fillable Fileable

Health Consumer Health and Safety

09-19-0001 - Records of Persons Exposed or Potentially Exposed to Hazardous or Toxic Substances  59 FR 67085

300 0
   
Individuals or Households
 
   100 %

  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 300 0 300 0 0 0
Annual IC Time Burden (Hours) 150 0 150 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
0923-0048 GenIC Submission Form 10/22/2018
Privacy Act Statement 10/22/2018
Adult Consent Form 10/22/2018
Parental Permission Form - Children under 18 Years of Age 10/22/2018
Child Assent Form - Children between 7-17 Years of Age 10/22/2018
Human Subjects Research Determination Form 10/22/2018
Example Results Letter 10/22/2018
Exposure Investigation Report (Example: FORMER UNITED ZINC & ASSOCIATED SMELTERS - Iola, Kansas) 10/22/2018
Privacy Impact Assessment 10/22/2018
Exposure Investigation Protocol 10/22/2018
Supporting Statement A 10/22/2018
Supporting Statement B 10/22/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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