Information Collection

10 CFR 26, Fitness for Duty Program

IC 33422 under ICR 202604-3150-008 · OMB 3150-0146.

Documents and Forms

Document Name Document Type
Form NRC Form 890 Single Positive Test Form 10 CFR 26, Fitness for Duty Program Form
Form NRC Form 891 Annual Reporting Form for Drug and Alcohol Tests 10 CFR 26, Fitness for Duty Program Form
Form NRC Form 892 Annual Fatigue Reporting Form 10 CFR 26, Fitness for Duty Program Form
RG 5.95 Access Authorization Program for Commercial Nuclear Plants Clean.docx Instruction
RG 5.99 Fatigue Management Clean.docx Instruction
NRC Form 890 Single Positive Test Form NRC Form 890, Single Positive Test Form.pdf Form
NRC Form 891 Annual Reporting Form for Drug and Alcohol Tests NRC Form 891, Annual Reporting Form for Drug and Alcohol Tests.pdf Form
NRC Form 892 Annual Fatigue Reporting Form NRC Form 892, Annual Fatigue Reporting Form.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	10 CFR 26, Fitness for Duty Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 10 CFR 26

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NRC Form 890	Single Positive Test Form	NRC Form 890, Single Positive Test Form.pdf	Yes	Yes	Fillable Fileable
Form	NRC Form 891	Annual Reporting Form for Drug and Alcohol Tests	NRC Form 891, Annual Reporting Form for Drug and Alcohol Tests.pdf	Yes	Yes	Fillable Fileable
Form	NRC Form 892	Annual Fatigue Reporting Form	NRC Form 892, Annual Fatigue Reporting Form.pdf	Yes	Yes	Fillable Fileable
Instruction			RG 5.95 Access Authorization Program for Commercial Nuclear Plants Clean.docx	Yes	Yes	Fillable Fileable
Instruction			RG 5.99 Fatigue Management Clean.docx	Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 70,560	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Program Change Due to New Statute	Previously Approved
Annual Number of Responses for this IC	325,616	970	324,646
Annual IC Time Burden (Hours)	549,105	9,055	540,050
Annual IC Cost Burden (Dollars)	20,370	0	20,370

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.

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