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View Information Collection (IC)
View Information Collection (IC)
IC Title:
Lower Duwamish Waterway Superfund Site Institutional Control Implementation Assurance Plan (ICIAP) "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms
Agency IC Tracking Number:
2434.211
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
6700-013
Public Health Seattle & King County EPA Outreach Event Survey
2024_OutreachEventSurvey.pdf
Yes
Yes
Fillable Fileable
Form
6700-014
Moms and Caregivers Self-Assessment (Multiple Languages)
2024_MomsWG_SelfAssessment.pdf
Yes
Yes
Fillable Fileable
Form
6700-015
Moms and Caregivers Pledges (Multiple Languages)
2024_MomsWG_Pledges.pdf
Yes
Yes
Fillable Fileable
Form
6700-016
Moms and Caregivers Mini Quiz (Multiple Languages)
2024_MomsWG_MiniQuiz.pdf
Yes
Yes
Fillable Fileable
Form
6700-017
Moms and Caregivers Background Survey (Multiple Languages)
2024_MomsWG_BackgroundSurvey.pdf
Yes
Yes
Fillable Fileable
Form
6700-018
Fishers Workshop PRE-Survey (Multiple Languages)
2024_FishersWG_PreSurvey.pdf
Yes
Yes
Fillable Fileable
Form
6700-019
Fishers Workshop POST-Survey (Multiple Languages)
2024_FishersWG_PostSurvey.pdf
Yes
Yes
Fillable Fileable
Form
6700-020
Fishers Workshop Pledges (Multiple languages)
2024_FishersWG_Pledges.pdf
Yes
Yes
Fillable Fileable
Form
6700-021
CHA Behavior Survey
2024_CHABehaviorSurvey.pdf
Yes
Yes
Fillable Fileable
Form
6700-022
Pre-Assessment of CHAs-in-Training
2024_PREcurric_Final.pdf
Yes
Yes
Fillable Fileable
Form
6700-023
Post-Assessment of CHAs-in-Training
2024_POSTcurric_FINAL.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Environmental Management
Subfunction:
Environmental Monitoring and Forecasting
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
675
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
675
0
675
0
0
0
Annual IC Time Burden (Hours)
323
0
323
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Justification
R10_Lower Duwamish Waterway ICIAP Program Eval_Generic Customer Service Collection Request.docx
03/21/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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