Drinking Water Information Collection (Environmental Protection Agencies)

[ATSDR] Human Health Effects of Drinking Water Exposures to Per- and Polyfluoroalkyl Substances (PFAS): A Multi-site Cross-sectional Study

Documents and Forms

Document Name Document Type
Drinking Water Information Collection (Environmental Protection Agencies) Form and Instruction
Water Information Collection Form for Environmental Prot M_Att3d_WaterInfoCollec_EnvironPrtctnAgencies_CLEAN.docx Form and Instruction
Water Information Collection Form for Environmental Prot M_Att3d_WaterInfoCollec_EnvironPrtctnAgencies_CLEAN.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Drinking Water Information Collection (Environmental Protection Agencies)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Water Information Collection Form for Environmental Protection Agencies	M_Att3d_WaterInfoCollec_EnvironPrtctnAgencies_CLEAN.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	7	7
Annual IC Time Burden (Hours)	49	49
Annual IC Cost Burden (Dollars)	1,186	1,186

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.