Primacy Agencies

Annual Public Water Systems Compliance Report (Renewal)

Documents and Forms

Document Name Document Type
1812supp04 - Justification for no CFR or Instrument.doc Other-No CFR or Instrument
1812supp04 - Justification for no CFR or Instrument.doc Other-No CFR or Instrument

Information Collection (IC) Details

IC Title:	Primacy Agencies	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-No CFR or Instrument			1812supp04 - Justification for no CFR or Instrument.doc		No	No	Printable Only

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 55	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 24 %

	Approved	Previously Approved
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	4,400	4,400
Annual IC Cost Burden (Dollars)	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.