Community Environmental Concerns Survey

Community Environmental Concerns Survey for U.S. Navy Clean-Up Actions

Documents and Forms

Document Name Document Type
0703-EGEN_community environmental concerns survey_7.10.2023.docx Other-Survey

Information Collection (IC) Details

IC Title:	Community Environmental Concerns Survey	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
Other-Survey			0703-EGEN_community environmental concerns survey_7.10.2023.docx		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 178	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	178	178
Annual IC Time Burden (Hours)	59	59
Annual IC Cost Burden (Dollars)	4,341	4,341

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.