View Information Collection (IC)

View Information Collection (IC)

IC Title:	Respiratory Protection (29 CFR 1910.134)	Agency IC Tracking Number:	1218-0099(2014)

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1910.134

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	29 CFR 1910.134	Respirator Medical Evaluation Questionnaire	1910.134 OSHA Respirator Medical Evaluation Questionnaire (2).docx		No		Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 616,035	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	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	23,443,707	0	0	2,004,711	0	21,438,996
Annual IC Time Burden (Hours)	6,971,401	0	-150,432	479,296	0	6,642,537
Annual IC Cost Burden (Dollars)	296,098,562	0	0	107,253,871	0	188,844,691

Documents for IC

Title	Document	Date Uploaded
Appendix C Respirator Med. Questionnaire	Appendix C Respirator medical Evaluation Questionnaire Adobe.pdf	08/16/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.