Information Collection Request
Radiation Sampling and Exposure Records
ICR 202502-1219-002 · OMB 1219-0003 · Active
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form MSHA 4000-9 Radiation Sampling and Exposure Records |
Form and Instruction | Modified | Repair queued |
 Justification for No Material and Non substantive Change.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-03-05 | Repair queued |
 1219-0003 Published 60 Day FRN 3-21-2023.pdf |
Supplementary Document | Uploaded 2023-08-28 | Repair queued |
| 1219-0003 Supporting Statement 2023.docx |
Supporting Statement A | Uploaded 2023-08-28 | Available |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 14336 |  Radiation Sampling and Exposure Records |
Form and Instruction | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | DOL/MSHA |
| OMB Control No | 1219-0003 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202303-1219-001 |
| Date Submitted to OIRA | 2025-04-07 |
| Requested Expiration Date | 1969-12-31 |