Radiographic Facility Certification (CDC/NIOSH 2.11)

National Coal Workers' Health Surveillance Program (CWHSP)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0020 can be found here:

Documents and Forms

Document Name Document Type
Form 2.11 Radiographic Facility Certification (CDC/NIOSH 2.11) Form
2.11 Radiograph Facility Certification Attachment 6 Radiograph Facility Cert 2.11.docx Form
2.11 Radiograph Facility Certification Attachment 6 Radiograph Facility Cert 2.11.docx Form

Information Collection (IC) Details

IC Title:	Radiographic Facility Certification (CDC/NIOSH 2.11)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	2.11	Radiograph Facility Certification	Attachment 6 Radiograph Facility Cert 2.11.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: Morbidity Studies in Coal Mining, Metal and Non-metal Mining and General Industry	FR Citation: 51 FR 42476

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	20	-20	40
Annual IC Time Burden (Hours)	10	-10	20
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.