Occupational Noise Exposure

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0120 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Occupational Noise Exposure	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 62.110(d) 30 CFR 62.130(a) 30 CFR Section 62.171(b) 30 CFR Section 62.172(a)(1) and (a)(2 30 CFR Section 62.174(a) 30 CFR Section 62.175(a)(1) and (a)(2 30 CFR 62.180(b) 30 CFR 62.190(a)&(b) (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

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,953	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	184,435	5,249	179,186
Annual IC Time Burden (Hours)	13,680	385	13,295
Annual IC Cost Burden (Dollars)	31,926	904	31,022

Documents for IC

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