Contents of a Request for Health Hazard Evaluation 42 CFR 85.3-1

ICR 199508-0920-004

OMB: 0920-0102

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0920-0102 199508-0920-004
Historical Active 199208-0920-003
HHS/CDC
Contents of a Request for Health Hazard Evaluation 42 CFR 85.3-1
Extension without change of a currently approved collection   No
Regular
Approved without change 09/13/1995
Retrieve Notice of Action (NOA) 08/22/1995
  Inventory as of this Action Requested Previously Approved
10/31/1998 10/31/1998 11/30/1995
500 0 0
100 0 100
0 0 0

The Health Hazard Evaluation (HHE) Program was designed to assist the National Institute for Occupational Safety and Health (NIOSH) in recommending new standards for workers exposed to harmful physical agents or toxic substances, to assess the validity of existing standards, to provide individual workplaces with a resource for determining if toxic substances or harmful physical agents are present in their environment, and if they are present, whether they represent a potential health hazard.

None
None


No

1
IC Title Form No. Form Name
Contents of a Request for Health Hazard Evaluation 42 CFR 85.3-1

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 500 0 0 500 0 0
Annual Time Burden (Hours) 100 100 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/22/1995


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