| USDA - RUS |
|
Title of Information Document |
|
|
|
|
|
OMB No. |
|
|
|
|
|
|
|
|
|
|
|
0572-0110 |
|
| SUMMARY OF INFORMATION COLLECTION |
|
7 CFR 1778 Emergency and Imminent Community Water |
|
|
|
|
|
Date Prepared |
|
|
|
|
|
Assistance Grants |
|
|
|
|
|
Nov-18 |
|
| INSTRUCTIONS: |
|
|
|
> |
(f) TOTAL |
|
(h) TOTAL |
|
(k) TOTAL |
|
| Use this form when a single information collection document involves multiple reporting and |
|
|
|
> |
- |
= (e) Average |
- |
= (g) Average |
- |
= (j) Average |
| recordkeeping requirements. |
|
|
|
> |
(d) TOTAL |
|
(f) TOTAL |
|
(i) TOTAL |
|
| IDENTIFICATION OF REPORTING AND RECORDKEEPPING REQUIREMENTS |
|
|
|
|
|
ANNUAL BURDEN |
|
|
|
|
|
|
FORM |
|
|
REPORTS |
|
|
|
RECORDS |
|
|
|
NO(s) |
NO. OF |
NO. OF |
TOTAL |
HOURS |
TOTAL |
NO. OF |
ANNUAL |
TOTAL |
| SECTION OF |
|
(If "none" |
RESPON- |
RESPONSES |
ANNUAL |
PER |
HOURS |
RECORD- |
HOURS PER |
RECORD- |
| REGULATIONS |
DESCRIPTION |
so state) |
DENTS |
PER |
RESPONSES |
RESPONSE |
(Col. f & g) |
KEEPERS |
RECORD- |
KEEPING |
|
|
|
|
RESPON- |
(Col. d & e) |
|
|
|
KEEPER |
HOURS |
|
|
|
|
DENT |
|
|
|
|
|
(Col. i & j) |
| (a) |
(b) |
(c) |
(d) |
(e) |
(f) |
(g) |
(h) |
(i) |
(j) |
(k) |
|
|
|
|
|
|
|
|
|
|
|
| 1778.1 (a) |
Relationship or association with RUS employees |
FmHA 1900-D |
52 |
1 |
52 |
0.25 |
13.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.6 (b) |
Evidence that imminent threat is likely to occur within one year; or, documentaion that significant event occurred within 2 years |
written |
52 |
1 |
52 |
2.00 |
104.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.7 |
Supporting Documentation (organizational, financial, insurance) |
written |
52 |
1 |
52 |
2.00 |
104.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.10 (a) (2) |
Documentation of Income Survey |
written |
5 |
1 |
5 |
8.00 |
40.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.14 (b) |
Environmental Report |
written |
52 |
1 |
52 |
24.00 |
1,248.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.14 (f) |
Intergovernmental comments |
written |
10 |
1 |
10 |
1.00 |
10.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.14 (g) |
Cert. for Contracts, Grants, and Loans (Regarding Lobbying) |
RD 1940-Q |
52 |
1 |
52 |
0.25 |
13.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.21 (a) |
Preliminary engineering report |
written |
52 |
1 |
52 |
24.00 |
1,248.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.22 |
Cert. from the State agency or the EPA confirming conformance with SWDA |
written |
52 |
1 |
52 |
2.00 |
104.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.23 (b) |
Grant Agreement |
RUS Bulletin 1780-12 |
40 |
1 |
40 |
1.00 |
40.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SUBTOTAL |
|
419 |
|
419 |
|
2,924 |
0.00 |
|
0.00 |
|
TOTAL OF ALL PAGES |
|
419 |
|
419 |
|
2,924 |
0 |
|
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
FORMS APPROVED UNDER OTHER OMB NUMBERS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.14 (a) |
Initial Compliance Review |
RD 400-8 |
41 |
1 |
41 |
8.00 |
328.00 |
|
|
|
|
|
(0575-0018) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.14 (e ) |
Certification Regarding Debarment |
AD-1047 & |
41 |
1 |
41 |
0.25 |
10.25 |
|
|
|
|
|
AD-1048 |
|
|
|
|
|
|
|
|
|
|
(0505-0027) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1778.14 (i) |
Certification Regarding Drug-Free Workplace |
AD-1049 |
41 |
1 |
41 |
0.25 |
10.25 |
|
|
|
|
|
(0505-0027) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SUBTOTAL |
|
123 |
|
123 |
|
349 |
|
|
|
|
Total of all Pages |
|
123 |
|
123 |
|
349 |
|
|
|
| RUS Form 36 (07-91) |
|
|
|
|
|
|
|
|
Page __1__ of __1__ |
|