Chemical Stockpile Emergency Preparedness Program (CSEPP) Evaluation and Customer Satisfaction Survey

Forms and Documents

Document Name	Status
Form FEMA Form 142-1-2 Open Ended Questionaire Form	Removed
Form FEMA Form 008-0-3I Pueblo EPZ Residential Survey/ FEMA Form 008-0-3INT Form and Instruction	New
Form FEMA Form 142-1-3 Pine Bluff Site Survey Form	Removed
Form FEMA Form 142-1-4 Anniston Site Survey Form	Removed
Alabama_FinalReport_20July2009.pdf Supplementary Document	2011-08-30
Pine_Bluff_Survey_Report_MASTER_01Oct2007.pdf Supplementary Document	2011-08-30
Survey_Evaluation_Report_FINAL_1Oct2007.pdf Supplementary Document	2011-08-30
Fiscal_Year_2010_CSEPP_Report_to_Congress.final.pdf Supplementary Document	2011-08-30
PTA, FEMA-CSEPP, DHS Contact Lists, 20110706, priv final.pdf Supplementary Document	2011-07-07
NARRATIVE OF CHANGES Supporting Statement 4-20-2011 PART A.docx Supplementary Document	2011-04-20
PUBLISHED 30 Day FRN 1660-0057 4-20-11.pdf Supplementary Document	2011-04-20
DHS PTA_final.doc Supplementary Document	2011-04-18
1660-0057 PUBLISHED 60 Day FRN 12-31-11.pdf Supplementary Document	2011-04-18
TITLE 50 Section 1521.doc Supplementary Document	2008-04-18
Supporting Statement 1660-0057 1-10-2011 PART B.docx Supporting Statement B	2011-09-30
Supporting Statement 1-10-2011 PART A.docx Supporting Statement A	2011-08-30
GPRA Public Law 103_62.pdf Supplementary Document	2008-04-18
Title 44 CFR 2.42.doc Supplementary Document	2008-04-16

IC Document Collections

IC ID	Document Title	Status
21134	Open Ended Questionaire Form	Removed
197357	Umatilla EPZ Residential Survey/ FEMA Form 008-0-6 Other-Telephone Survey	New
197356	Pueblo EPZ Business Survey/ FEMA Form 008-0-5 Other-Telephone Survey	New
197354	Pueblo City Residential Survey/ FEMA Form 008-0-4 Other-Telephone Survey	New
197353	Pueblo EPZ Residential Survey/ FEMA Form 008-0-3INT Form and Instruction	New
197352	Pueblo EPZ Residential Survey/ FEMA Form 008-0-3 Other-Telephone Survey	New
197351	Deseret EPZ Residential Survey/ FEMA Form 008-0-8 Other-Telephone Survey	New
197350	Blue Grass EPZ Residential Survey/ FEMA Form 008-0-7 Other-Telephone Survey	New
184564	Pine Bluff Site Survey Form	Removed
184562	Anniston Site Survey Form	Removed

ICR Details

OMB Control No: 1660-0057	ICR Reference No: 201103-1660-003
Status: Historical Active	Previous ICR Reference No: 200711-1660-001
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Chemical Stockpile Emergency Preparedness Program (CSEPP) Evaluation and Customer Satisfaction Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/16/2011
	Date Received in OIRA: 05/06/2011
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2014	36 Months From Approved	10/31/2011
Responses	3,715	0	2,224
Time Burden (Hours)	900	0	556
Cost Burden (Dollars)	0	0	0

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Abstract: To support the development of public outreach and education efforts that will improve the emergency preparedness, FEMA's Chemical Stockpile Emergency Preparedness Program (CSEPP) will collect data from the citizens living in the Immediate Response Zones (IRZ) and Protective Action Zones (PAZ) surrounding stockpile sites. Program managers use survey data findings to evaluate public awareness of protective actions at CSEPP sites, and identify outreach weaknesses and strengths to develop effective outreach and education campaigns. Results from this information collection are shared with State, local, Tribal, and other FEMA officials for subsequent action plans addressing program-wide and stockpile site-specific issues. Results are also shared with other Federal agencies that lend expertise in specific areas of the program.

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Authorizing Statute(s): PL: Pub.L. 103 - 62 4 Name of Law: Government Performance and Results Act of 1973
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 5392	01/31/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 22116	04/20/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

IC Title	Form No.	Form Name
Open Ended Questionaire	FEMA Form 142-1-2	Open Ended Questionaire
Blue Grass EPZ Residential Survey/ FEMA Form 008-0-7
Umatilla EPZ Residential Survey/ FEMA Form 008-0-6
Pueblo EPZ Residential Survey/ FEMA Form 008-0-3INT	FEMA Form 008-0-3INT	Pueblo EPZ Residential Survey (Internet)
Pueblo EPZ Business Survey/ FEMA Form 008-0-5
Pine Bluff Site Survey	FEMA Form 142-1-3	Pine Bluff Site Survey
Anniston Site Survey	FEMA Form 142-1-4	Anniston Site Survey
Deseret EPZ Residential Survey/ FEMA Form 008-0-8
Pueblo City Residential Survey/ FEMA Form 008-0-4
Pueblo EPZ Residential Survey/ FEMA Form 008-0-3

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ICR Summary of Burden

	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	3,715	2,224	0	1,491	0	0
Annual Time Burden (Hours)	900	556	0	344	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: FEMA Form 008-0-7 is a new form. This form is the telephone survey questionnaire for the CSEPP site in Kentucky and the current estimated annual hour burden is 205.5, resulting in an increase (program change) of 205.5 hours. The increase in burden hours results from an increase in annual responses due to addition of Blue Grass site. FEMA Form 008-0-8 is a new form. This form is the telephone survey questionnaire for the CSEPP site in Utah and the current estimated annual hour burden is 205.75, resulting in an increase (program change) of 205.75 hours. The increase in burden hours results from an increase in annual responses due to addition of Deseret site. FEMA Form 008-0-3 is a new form. This form is the telephone survey questionnaire for the CSEPP site in Colorado and the current estimated annual hour burden is 184.25, resulting in an increase (program change) of 184.25 hours. The increase in burden hours results from an increase in annual responses due to addition of Pueblo site. FEMA Form 008-0-3INT is a new form. This form is the internet survey questionnaire for the CSEPP site in Colorado and the current estimated annual hour burden is 12.5, resulting in an increase (program change) of 12.5 hours. The increase in burden hours results from an increase in annual responses due to addition of Pueblo site. FEMA Form 008-0-4 is a new form. This form is the telephone survey questionnaire for the residential survey to be conducted in the Pueblo City area. The current estimated annual hour burden is 65.11, resulting in an increase (program change) of 65.11 hours. The increase in burden hours results from an increase in annual responses due to addition of Pueblo site. FEMA Form 008-0-5 is a new form. This form is the telephone survey questionnaire for the businesses near the CSEPP site in Colorado and the current estimated annual hour burden is 21.5, resulting in an increase (program change) of 21.5 hours. The increase in burden hours results from an increase in annual responses due to addition of Pueblo site. FEMA Form 008-0-6 is a new form. This form is the telephone survey questionnaire for the CSEPP site in Oregon and the current estimated annual hour burden is 203.5, resulting in an increase (program change) of 203.5 hours. The increase in burden hours results from an increase in annual responses due to addition of Umatilla site. FEMA Form 142-1-2 will no longer be used by the program office, resulting in decrease (adjustment) of 42.5 hours. Reasons for the adjustments include the fact that as the demilitarization of chemical weapons progresses some CSEPP sites are nearing closeout and anticipate no need for future surveys. FEMA Form 142-1-3 will no longer be used by the program office, resulting in decrease (adjustment) of 240.25 hours. Reasons for the adjustments include the fact that as the demilitarization of chemical weapons progresses some CSEPP sites are nearing closeout and anticipate no need for future surveys. FEMA Form 142-1-4 will no longer be used by the program office, resulting in decrease (adjustment) of 273.25 hours. Reasons for the adjustments include the fact that as the demilitarization of chemical weapons progresses some CSEPP sites are nearing closeout and anticipate no need for future surveys.

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Annual Cost to Federal Government: $274,973

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/06/2011

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