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Occupational Safety and Health Variance Regulation
Occupational Safety and Health Act Variance Regulations (29 CFR 1905.10, 1905.11 and 1905.12)
OMB: 1218-0265
IC ID: 199154
OMB.report
DOL/OSHA
OMB 1218-0265
ICR 201501-1218-003
IC 199154
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0265 can be found here:
2022-02-18 - Extension without change of a currently approved collection
2018-06-29 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
oshaform5-30-1a.pdf
Instruction
oshaform5-30-2a.pdf
Instruction
oshaform5-30-3a.pdf
Instruction
oshaform5-30-4a.pdf
Instruction
OSHA Form5-30-1 Experimental Variance Application
OSHAForm5-30-1.pdf
www.osha.gov/dts/otpca/variances/experimental_variance_app_form.pdf
Form
OSHA Form 5-30-2 Temporary Variance Application
OSHAForm5-30-2.pdf
www.osha.gov/dts/otpca/variances/temp_variance_app_form.pdf
Form
OSHA Form 5-30-3 Permanent Variance Application
OSHAForm5-30-3.pdf
www.osha.gov/dts/otpca/variances/permanent_variance_app_form.pdf
Form
OSHA Form 5-30-4 National Defense Variance Application
OSHAForm5-30-4.pdf
www.osha.gov/dts/otpca/variances/national_defence_variance_app_form.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Occupational Safety and Health Variance Regulation
Agency IC Tracking Number:
Is this a Common Form?
Yes
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
29 CFR Part 1905 (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
oshaform5-30-1a.pdf
Yes
No
Printable Only
Instruction
oshaform5-30-2a.pdf
Yes
No
Printable Only
Instruction
oshaform5-30-3a.pdf
Yes
No
Printable Only
Instruction
oshaform5-30-4a.pdf
Yes
No
Printable Only
Form
OSHA Form5-30-1
Experimental Variance Application
OSHAForm5-30-1.pdf
https://www.osha.gov/dts/otpca/variances/experimental_variance_app_form.pdf
Yes
No
Fillable Printable
Form
OSHA Form 5-30-2
Temporary Variance Application
OSHAForm5-30-2.pdf
https://www.osha.gov/dts/otpca/variances/temp_variance_app_form.pdf
Yes
No
Fillable Printable
Form
OSHA Form 5-30-3
Permanent Variance Application
OSHAForm5-30-3.pdf
https://www.osha.gov/dts/otpca/variances/permanent_variance_app_form.pdf
Yes
No
Fillable Printable
Form
OSHA Form 5-30-4
National Defense Variance Application
OSHAForm5-30-4.pdf
https://www.osha.gov/dts/otpca/variances/national_defence_variance_app_form.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Worker Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
12
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
12
0
0
0
0
12
Annual IC Time Burden (Hours)
366
0
0
0
0
366
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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.