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Federal forms, ICRs, and supporting documents

Information Collection Request

Evaluation of Efficacy of Household Water Filtration/Treatment Devices in Households with Private Wells

ICR 200410-0920-005 · OMB 0920-0670 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
7138 Evaluation of Efficacy of Household Water Filtration/Treatment Devices in Households with Private Wells Migrated
ICR Details
0920-0670 200410-0920-005
Historical Active
HHS/CDC
Evaluation of Efficacy of Household Water Filtration/Treatment Devices in Households with Private Wells
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 03/17/2005
Retrieve Notice of Action (NOA) 10/20/2004
OMB approves the collection of information under the following terms: CDC may share geo-reference data collected under this project with EPA and USGS provided that the agency obtains written consent in advance from respondents for such purposes. Any data shared shall include a discussion of the study design and its limitations, and all data must be used in a manner consistent with each agencies respective data quality guidelines.
  Inventory as of this Action Requested Previously Approved
10/31/2005 10/31/2005
1,800 0 0
300 0 0
0 0 0
This study will evaluate how water treatment device efficacy is affected by user behaviors such as maintenance and selection of appropriate technologies. The study will recruit 600 households from seven states to help us determine whether people using water treatment devices are protected from exposure to contaminants found in their well water. A questionnaire will be used to obtain information on selection of water treatment types, adherence to suggested maintenance, and reasons for use of treatment device. We will also collect samples of treated water and untreated well water at each household to...
None
None
No
1
IC Title Form No. Form Name
Evaluation of Efficacy of Household Water Filtration/Treatment Devices in Households with Private Wells
  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 1,800 0 0 1,800 0 0
Annual Time Burden (Hours) 300 0 0 300 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
Yes Part B of Supporting Statement
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.
10/20/2004