Information Collection

Onsite Consultation Agreements (29 CFR Part 1908) State Projects

IC 14039 under ICR 202409-1218-003 · OMB 1218-0110.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0110 can be found here:

Documents and Forms

Document Name Document Type
OSHA_INSTRUCTION(CPPM)_final_1-18-08.doc Instruction
PSM Evaluation Worksheet.docx Other-worksheet
Apx E Interim-Year SHARP Self-Eval (CPPM doc).docx Other-worksheet
Apx F-1 SHP Action Plan Template (Apx F - CPPM doc).docx Other-worksheet
Apx F-2 Optional SHP Action Plan Tool (Apx F -CPPM doc).docx Other-worksheet
Apx L-2 PSM SHARP Self-Eval.docx Instruction
Apx L-3 Determining Applicability of PSM.docx Instruction
Apx M- Incident Investigation Report_Updated 11-13-24.docx Other-worksheet
Table C-1 Optional PSM Wksht (for PSM Eval Wksht).docx Other-worksheet
Table C-2 Optional PSM Wksht (for PSM Eval Wksht).docx Other-worksheet
Table D Optional PSM Wksht (for PSM Eval Wksht).docx Other-worksheet
Table E Optional PSM Wksht (for PSM Eval Wksht).docx Other-worksheet
Table M Optional PSM Wksht (for PSM Eval Wksht).docx Other-worksheet
Form 33 Safety and Health Program Assessment Worksheet Safety and Health Program Assessment Worksheet Form 33 (January 2022) .docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Onsite Consultation Agreements (29 CFR Part 1908) State Projects	Agency IC Tracking Number:	1218-0110 (2024)

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 1908

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			OSHA_INSTRUCTION(CPPM)_final_1-18-08.doc	Yes	No	Fillable Printable
Form	Form 33	Safety and Health Program Assessment Worksheet	Safety and Health Program Assessment Worksheet Form 33 (January 2022) .docx	Yes	Yes	Fillable Fileable
Other-worksheet			PSM Evaluation Worksheet.docx	No		Fillable Printable
Other-worksheet			Apx E Interim-Year SHARP Self-Eval (CPPM doc).docx	No		Fillable Printable
Other-worksheet			Apx F-1 SHP Action Plan Template (Apx F - CPPM doc).docx	No		Fillable Printable
Other-worksheet			Apx F-2 Optional SHP Action Plan Tool (Apx F -CPPM doc).docx	No		Fillable Printable
Instruction			Apx L-2 PSM SHARP Self-Eval.docx	No		Printable Only
Instruction			Apx L-3 Determining Applicability of PSM.docx	No		Printable Only
Other-worksheet			Apx M- Incident Investigation Report_Updated 11-13-24.docx	No		Fillable Printable
Other-worksheet			Table C-1 Optional PSM Wksht (for PSM Eval Wksht).docx	No		Fillable Printable
Other-worksheet			Table C-2 Optional PSM Wksht (for PSM Eval Wksht).docx	No		Fillable Printable
Other-worksheet			Table D Optional PSM Wksht (for PSM Eval Wksht).docx	No		Fillable Printable
Other-worksheet			Table E Optional PSM Wksht (for PSM Eval Wksht).docx	No		Fillable Printable
Other-worksheet			Table M Optional PSM Wksht (for PSM Eval Wksht).docx	No		Fillable Printable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	53,472	-16,789	70,261
Annual IC Time Burden (Hours)	175,607	-41,082	216,689
Annual IC Cost Burden (Dollars)	0	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.