View Information Collection Request (ICR) Package
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Brief and OIRA conclusion
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Burden
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Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0260
ICR Reference No:
200807-0920-003
Status:
Historical Active
Previous ICR Reference No:
200504-0920-003
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
Health Hazard Evaluations/Technical Assistance and Emerging Problems
Type of Information Collection:
Reinstatement with change of a previously approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/08/2009
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/16/2008
Terms of Clearance:
Approved consistent with the following terms of clearance: approved for purposes of conducting investigations/evaluations, given the anecdotal nature of gathered data information obtained through these collections of information will not be used to develop estimates related to health or safety risks in general.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2012
36 Months From Approved
Responses
11,690
0
0
Time Burden (Hours)
4,007
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
Pursuant to its mandates under the Occupational Safety and Health Act of 1970 and the Federal Mine Safety and Health Act of 1977, and authorized by 42 CFR 85, NIOSH responds to requests for health hazard evaluations (HHEs) to identify chemical, biological or physical hazards in workplaces and provide guidance to reduce any hazards found. This is a request for reinstatement with minor changes.
Authorizing Statute(s):
PL:
Pub.L. 91 - 596 20
Name of Law: Occupational Safety and Health Act
PL:
Pub.L. 91 - 173 301
Name of Law: Federal Mine Safety and Health Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
73 FR 19504
04/10/2008
30-day Notice:
Federal Register Citation:
Citation Date:
73 FR 38222
07/03/2008
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
8
IC Title
Form No.
Form Name
Closeout Evaluation
Followback I
Followback II
Health Hazard Evaluation Request Form for Employees and Employers
Health Hazard Evaluation Specific Interview (Example)
Health Hazard Evaluation Specific Questionnaire (Example)
Initial Site Visit Survey Form
One Year Later Evaluation
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
11,690
0
0
11,690
0
0
Annual Time Burden (Hours)
4,007
0
0
4,007
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
This is a request for reinstatement with minor changes to forms which slightly reduce the burden and number of respondents.
Annual Cost to Federal Government:
$385,000
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Carol Walker 4046394773
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
07/16/2008
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