View Information Collection (IC)

View Information Collection (IC)

IC Title:	Impact of Heating Stove Replacement on Indoor and Outdoor Pollutants and Respiratory Health in Shiprock, NM, Navajo Nation	Agency IC Tracking Number:	2521.11

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	2521ss11 Stove Replacement Instrument	2521ss11 Stove Replacement Instruments.docx		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: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	1,400	0	1,400	0	0	0
Annual IC Time Burden (Hours)	383	0	383	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Justification	2521ss11 Stove Replacement Justification.docx	08/07/2018

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