| OMB 1910-0300, Environment, Safety and Health (ES&H) Reporting Systems Package -- Detail for Item 13 and 14 (Supporting Statement) |
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| Collections are submitted 100% electonically. |
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| No. |
Collection Title |
FY |
Estimated Annual Respondents |
Estimated Annual Responses |
Estimated Hourly Wage for Respondents or Recordkeepers |
FY 2015 Estimated Annual Burden Hours |
Estimated Costs to Respondents (Formula: $87 x burden hour) |
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| 1 |
DOE F 470.3, Human Reliability Program (HRP) Certification |
2016 |
9,455 |
9,472 |
$87 |
1,579 |
$137,373.00 |
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| 2 |
DOE F 470.4, Acknowledgement and Agreement to Participate in the Human Reliability Program (HRP) |
2016 |
9,094 |
9,105 |
$87 |
304 |
$26,448.00 |
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| 3 |
DOE 470.5, Authorization and consent to release Human Reliability Program (HRP) Records in Connection with the HRP |
2016 |
9,094 |
9,105 |
$87 |
304 |
$26,448.00 |
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| 4 |
DOE F 470.6, Refusal of Consent |
2016 |
0 |
0 |
$87 |
0 |
$- |
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| 5 |
DOE F 470.7, Human Reliability Program (HRP) Alcohol Testing Form |
2016 |
16,317 |
16,317 |
$87 |
1,632 |
$141,984.00 |
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TOTAL RESPONDENT COST |
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43,960 |
43,999 |
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3,819 |
$332,253.00 |
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Federal cost associated with this collection |
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$10,635.00 |
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Total |
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$342,888.00 |
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