OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Epidemiologic Study of Health Effects Associated with Low Pressure Events in Drinking Water Distribution Systems

ICR 201409-0920-014 · OMB 0920-0960 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Line Listings (Multi-site) Form Removed Repair queued
Att L_CDC Water and Health Study (paper questionnaire) Form Modified Available
Justification for Change 9-26-14.docx Justification for No Material/Nonsubstantive Change Uploaded 2014-09-26 Available
P.Final Appeal Letter.docx Supplementary Document Uploaded 2014-09-26 Repair queued
O.Replacement Survey Cover Letter.docx Supplementary Document Uploaded 2014-09-26 Repair queued
N.Thank youReminder Letter.docx Supplementary Document Uploaded 2014-09-26 Repair queued
K.Consent Brochure.pdf Supplementary Document Uploaded 2014-09-26 Available
J.Cover Letter Paper.docx Supplementary Document Uploaded 2014-09-26 Repair queued
I.Advance Letter (revised).docx Supplementary Document Uploaded 2014-09-26 Available
J.Cover Letter Paper.docx Supplementary Document Uploaded 2014-09-26 Available
E.IRB Approval Continuation.docx Supplementary Document Uploaded 2014-09-26 Available
C.Pilot Evaluation Log Frame.pdf Supplementary Document Uploaded 2014-09-26 Available
D.Phone script (revised).docx Supplementary Document Uploaded 2014-09-26 Available
Mini SupSta Part B 9-26-14.docx Supporting Statement B Uploaded 2014-09-26 Available
OMB Appendix B Federal Register 60 day notice 2012-7020.pdf Supplementary Document Uploaded 2013-03-22 Repair queued
OMB Appendix A Authorizing Legislation 42 CFR 241.pdf Supplementary Document Uploaded 2013-03-22 Available
Mini SupSta Part A 092614.docx Supporting Statement A Uploaded 2014-09-26 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
204806 Att H._Utility Customer Information Other-WORD Modified
204805 Att G._Low Pressure Event Form Other-WORD Modified
204804 Line Listings (Multi-site) Form Removed
204803 Att G_Low Pressure Event Form Other-WORD Modified
204802 Att L_CDC Water and Health Study (paper questionnaire) Form Modified
204801 Att M_CDC Water and Health Study (Web-Based Questionnaire) Other-Screen shots Modified
ICR Details
0920-0960 201409-0920-014
Historical Active 201211-0920-008
HHS/CDC 14AXX
Epidemiologic Study of Health Effects Associated with Low Pressure Events in Drinking Water Distribution Systems
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 11/12/2014
Retrieve Notice of Action (NOA) 10/03/2014
  Inventory as of this Action Requested Previously Approved
03/31/2016 03/31/2016 03/31/2016
2,095 0 2,291
571 0 585
0 0 0
Approximately 200 million cases of acute gastrointestinal illness (AGI) occur in the U.S. each year. The Centers for Disease Control and Prevention requests approval for data collection to assess whether individuals exposed to low pressure events in water distribution system are at increased risk for acute gastrointestinal or respiratory illnesses to the terms of clearance, a non-substantive change request is required after completion of the pilot study.
US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  77 FR 17066 03/23/2012
77 FR 65894 10/31/2012
Yes
  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 2,095 2,291 0 -196 0 0
Annual Time Burden (Hours) 571 585 0 -14 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
There increased estimated burden of 34 hours to complete the full study (571 hours compared to 537 hours in the original information request). Since completion of the pilot, which it was determined that we originally underestimated the amount of time required to collect and ship the ultrafiltration water samples.
$319,796
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Thelma Sims 4046394771
  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.
10/03/2014