NRC Form 5, Occupational Exposure Record for a Monitoring Period

OMB Control No: 3150-0006	ICR Reference No: 202008-3150-002
Status: Active	Previous ICR Reference No: 201706-3150-008
Agency/Subagency: NRC	Agency Tracking No:
Title: NRC Form 5, Occupational Exposure Record for a Monitoring Period
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/07/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/19/2020
Terms of Clearance: In accordance with 5 CFR 1320, this information collection is approved for 3 years. The agency may update the SORN citation in the accompanying Privacy Act Statement to reflect the most recent Federal Register notice without resubmission for approval.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2024	36 Months From Approved	01/31/2021
Responses	4,328	0	4,339
Time Burden (Hours)	106,906	0	125,373
Cost Burden (Dollars)	11,287	0	12,660

---

Abstract: The NRC Form 5, “Occupational Dose Record for Monitoring Period,” is used by NRC to compile and analyze occupational radiation dose information to assess the effectiveness of licensees’ radiation protection programs and uses this information for planning inspections at licensee’s facilities. NRC also uses this information to ensure that licensees are complying with the appropriate regulations to protect worker and public health and safety. Section 20.2206(c) requires licensees to submit their occupational radiation dose data, covering the preceding year, to NRC, on or before April 30 of each year. NRC Form 5 specifies the use of the individual's name, social security number or other unique identification, date of birth, and sex. This information is necessary to ensure the proper identification of the individual. NRC uses REIRView, a dose record data validation software, that assists in verification of file format of annual dose records submitted to the Radiation Exposure Information and Reporting System (REIRS).

---

Authorizing Statute(s): PL: Pub.L. 83 - 703 1-311 Name of Law: Atomic Energy 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:
	85 FR 25478	05/01/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 51069	08/19/2020
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 1

IC Title Form No. Form Name NRC Form 5, Occupational Exposure Record for a Monitoring Period NRC Form 5 Occupational Dose Record for a Monitoring Period

---

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	4,328	4,339	0	0	-11	0
Annual Time Burden (Hours)	106,906	125,373	0	0	-18,467	0
Annual Cost Burden (Dollars)	11,287	12,660	0	0	-1,373	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden decreased by 18,467 hours from 125,373 hours to 106,906 hours. The majority of this change can be attributed to a reduction in the number of monitored individuals reported by operating reactors. The NRC staff used the most recent data from the REIRS system (2018) to generate burden estimates for this supporting statement. The number of reported monitored individuals decreased from 184,635 in the last clearance to 150,214 in the current submission. This is consistent with a trend in which reactors are reporting fewer monitored workers annually. From 2015 onward, operating reactors have reported fewer monitored individuals each year. Based on experience and industry knowledge, the NRC anticipates that the number of monitored individuals during the upcoming clearance period will be similar to the data from 2018 used in these estimates. Additionally, the hourly fee rate increased from $265/hr to $278/hr.

---

Annual Cost to Federal Government: $630,782

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Minh-Thuy Nguyen 301 415-7000

---

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: 08/19/2020

---