Att C_Oil and Gas Workers Safety and Health Survey-Module 2,3,5 (WEB)

Assessing Safety and Health Hazards of Workers in Oil and Gas Extraction: A Survey

Documents and Forms

Document Name Document Type
Att C. Survey.docx Other-WEB

Information Collection (IC) Details

IC Title:	Att C_Oil and Gas Workers Safety and Health Survey-Module 2,3,5 (WEB)	Agency IC Tracking Number:	16AXC

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WEB			Att C. Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 225	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	225	225
Annual IC Time Burden (Hours)	94	94
Annual IC Cost Burden (Dollars)	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.