Assessing and Evaluating the Effectiveness of Hazard Recognition and Risk Assessment Interventions

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIOSH 2)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0953 can be found here:

Documents and Forms

Document Name Document Type
Att A_EXAMiner_Evaluation_Trainee.061518.docx Other-WORD
Att B_EXAMiner_Interview_Mine Safety and Health Professional.061518.docx Other-WORD
Att C_AreYouThinkingLikeanEXAMiner_Interviews.docx Other-WORD
Att C1_AreYouThinkingLikeanEXAMiner_Evaluation_Interview.docx Other-WORD
Att C2_AreYouThinkingLikeanEXAMiner_JobAid_Interview.061518.docx Other-WORD
Att D- Pre Job Aid.docx Other-WORD
Att D1_AreYouThinkingLikeanEXAMiner_Job Aid.061518.docx Other-WORD
Att D2- Post Job Aid.docx Other-WORD
GenICRequest2.061518.docx Request for Approval IC Document

Information Collection (IC) Details

IC Title:	Assessing and Evaluating the Effectiveness of Hazard Recognition and Risk Assessment Interventions	Agency IC Tracking Number:	0920-0953 (18AJZ)

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-WORD	Att A_EXAMiner_Evaluation_Trainee.061518.docx	No	Fillable Fileable
Other-WORD	Att B_EXAMiner_Interview_Mine Safety and Health Professional.061518.docx	No	Fillable Fileable
Other-WORD	Att C_AreYouThinkingLikeanEXAMiner_Interviews.docx	No	Fillable Fileable
Other-WORD	Att C1_AreYouThinkingLikeanEXAMiner_Evaluation_Interview.docx	No	Fillable Fileable
Other-WORD	Att C2_AreYouThinkingLikeanEXAMiner_JobAid_Interview.061518.docx	No	Fillable Fileable
Other-WORD	Att D- Pre Job Aid.docx	No	Fillable Fileable
Other-WORD	Att D1_AreYouThinkingLikeanEXAMiner_Job Aid.061518.docx	No	Fillable Fileable
Other-WORD	Att D2- Post Job Aid.docx	No	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 670	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	670	670
Annual IC Time Burden (Hours)	247	247
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	GenICRequest2.061518.docx	06/15/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.