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Radiographic Facility Certification (CDC/NIOSH (M) 2.11)
National Coal Workers' Health Surveillance Program (CWHSP)
OMB: 0920-0020
IC ID: 183369
OMB.report
HHS/CDC
OMB 0920-0020
ICR 201903-0920-009
IC 183369
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0020 can be found here:
2022-02-07 - Revision of a currently approved collection
2021-09-09 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 2.11
Radiographic Facility Certification (CDC/NIOSH (M) 2.11)
Form
2.11 Radiographic Facility Certification
Attachment 6.docx
Form
Attachment 7 03 11 2015.docx
Sample Letter to Radiographic Facility
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Radiographic Facility Certification (CDC/NIOSH (M) 2.11)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
2.11
Radiographic Facility Certification
Attachment 6.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
09-20-0149-Morbidity Studies in Coal Mining, Metal and Non-Metal Mining and General Industry and 0920-0153- Mortality Studies in coal Mining, Metal and Non-Metal Mining and General Industry.
FR Citation:
51 FR 42476
Number of Respondents:
40
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
40
0
0
0
0
40
Annual IC Time Burden (Hours)
20
0
0
0
0
20
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Sample Letter to Radiographic Facility
Attachment 7 03 11 2015.docx
03/19/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.