Information Collection

Filter Holder Log

IC 186177 under ICR 200808-1601-002 · OMB 1601-0006.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1601-0006 can be found here:

Documents and Forms

Document Name Document Type
Form DHS 9500 Filter Holder Log Form and Instruction
DHS 9500 Filter Holder Log OMB # 4 for Filter Holder Log.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Filter Holder Log	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	DHS 9500	Filter Holder Log	OMB # 4 for Filter Holder Log.pdf		No		Paper Only

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 522	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	190,008	190,008
Annual IC Time Burden (Hours)	3,173	3,173
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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