HRSA Environmental Information and Documentation (EID)

Forms and Documents

Document Name	Status
Form 1 Environmental Information and Documentation Checklist Form	Modified
HHS GAM Part 30.pdf Supplementary Document	2016-03-09
The National Environmental Policy Act of 1969.docx Supplementary Document	2016-03-09
Supporting Statement 2016 r5.doc Supporting Statement A	2016-03-09

IC Document Collections

IC ID	Document Title	Status
189032	Environmental Information and Documentation Checklist Form	Modified

ICR Details

OMB Control No: 0915-0324	ICR Reference No: 201603-0915-002
Status: Historical Active	Previous ICR Reference No: 201301-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: HRSA Environmental Information and Documentation (EID)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/09/2016
	Date Received in OIRA: 03/10/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	36 Months From Approved	05/31/2016
Responses	1,350	0	1,847
Time Burden (Hours)	1,350	0	1,385
Cost Burden (Dollars)	0	0	0

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Abstract: HRSA uses the information collected to make a determination as to NEPA compliance. Applicants provide the information requested in the EID in order to qualify to receive benefits in the form of grants for purposes outlined in the applicable law. The series of questions in the EID collects specific project and site related information not collected in other application forms. This information is needed to determine the level of review required under the National Environmental Policy Act (NEPA) and related laws. HRSA will use this information along with overall program applications to determine eligibility and the level of environmental review required under NEPA for construction related awards. For example, information submitted on the EID may show that the proposed project impact is minimal and therefore the project requires no further review under NEPA and other related laws. Alternatively, the results of the EID may also identify that the proposed project does require further review and evaluation such as: 1) the preparation and public notice of an Environmental Assessment under NEPA; 2) consultation under Section 106 of the National Historic Preservation Act (NHPA); 3) site testing for the presence of hazardous materials such as asbestos or lead; or 4) further consultation and coordination with other Federal Agencies on issues such as endangered species, floodplain management or wetland permits.

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Authorizing Statute(s): US Code: 42 USC 4321 Name of Law: National Environmental Policy Act
  

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:
	80 FR 245	12/22/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 36	02/24/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Environmental Information and Documentation Checklist	1	1

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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	1,350	1,847	0	-497	0	0
Annual Time Burden (Hours)	1,350	1,385	0	-35	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: New estimate in the number of respondents has reduced the estimated burden.

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Annual Cost to Federal Government: $500,000

Does this IC contain surveys, censuses, or employ statistical methods? No

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)? Yes

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: 03/10/2016

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