State Primacy Agencies (including Navajo Nation)

2020 Drinking Water Infrastructure Needs Survey and Assessment (NEW)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2040-0302 can be found here:

Documents and Forms

Document Name Document Type
Form 6100-01 State Primacy Agencies (including Navajo Nation) Form and Instruction
6100-01 2020 Drinking Water Infrastructure Needs Survey and Asse 6100-01 (Forms & Instructions).docx dwneeds.epa.gov Form and Instruction

Information Collection (IC) Details

IC Title:	State Primacy Agencies (including Navajo Nation)	Agency IC Tracking Number:

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
Form and Instruction	6100-01	2020 Drinking Water Infrastructure Needs Survey and Assessment	6100-01 (Forms & Instructions).docx	dwneeds.epa.gov	Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 57	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	19	0	19
Annual IC Time Burden (Hours)	7,525	528	6,997
Annual IC Cost Burden (Dollars)	0	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.