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Federal forms, ICRs, and supporting documents

Information Collection Request

Contents of a Request for Health Hazard Evaluation -- 42 CFR 85.3-1

ICR 200112-0920-002 · OMB 0920-0102 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
6632 Contents of a Request for Health Hazard Evaluation -- 42 CFR 85.3-1 Migrated
ICR Details
0920-0102 200112-0920-002
Historical Active 199808-0920-002
HHS/CDC
Contents of a Request for Health Hazard Evaluation -- 42 CFR 85.3-1
Extension without change of a currently approved collection   No
Regular
Approved without change 01/14/2002
Retrieve Notice of Action (NOA) 12/04/2001
  Inventory as of this Action Requested Previously Approved
01/31/2005 01/31/2005 01/31/2002
450 0 400
90 0 80
0 0 0
Health Hazard Evaluation request form as provided by the OSH Act and MSH Act and authorized by 42 CFR 85.
None
None
No
1
IC Title Form No. Form Name
Contents of a Request for Health Hazard Evaluation -- 42 CFR 85.3-1
  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 450 400 0 0 50 0
Annual Time Burden (Hours) 90 80 0 0 10 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/04/2001