July
5,
2006
SUPPLEMENTARY
STATEMENT
&
DRAFT
QUESTIONS:

INFORMATION
COLLECTION
REQUEST
for
ASSESSMENT
OF
EPA
PARTNERSHIP
PROGRAMS
EPA
The
United
States
Environmental
Protection
Agency
Table
of
Contents
Title
Page
1.
Identification
of
the
Information
Collection
1
1(
a)
Title
of
the
Information
Collection
1
1(
b)
Short
Characterization/
Abstract
1
2.
Need
for
and
Use
of
the
Collection
2
2(
a)
Need/
Authority
for
the
Collection
2
2(
b)
Practical
Utility/
Users
of
the
Data
2
3.
Non­
duplication,
Consultations,
and
Other
Collection
Criteria
3
3(
a)
Non­
duplication
3
3(
b)
Public
Notice
Required
Prior
to
ICR
Submission
to
OMB
3
3(
c)
Consultations
3
3(
d)
Effects
of
Less
Frequent
Collection
3
3(
e)
General
Guidelines
3
3(
f)
Confidentiality
3
3(
g)
Sensitive
Questions
3
4.
The
Respondents
and
The
Information
Requested
4
4(
a)
Respondents/
SIC
Codes
4
4(
b)
Information
Requested
4
(
i)
Data
items,
including
record
keeping
requirements
4
(
ii)
Respondent
activities
4
5.
The
Information
Collected­­
Agency
Activities,
Collection
Methodology,
and
Information
Management
4
5(
a)
Agency
Activities
4
5(
b)
Collection
Methodology
and
Management
5
5(
c)
Small
Entity
Flexibility
5
5(
d)
Collection
Schedule
5
6.
Estimating
the
Burden
and
Cost
of
the
Collection
5
6(
a)
Estimating
Respondent
Burden
5
6(
b)
Estimating
Respondent
Costs
7
(
i)
Estimating
Labor
Costs
7
(
ii)
Estimating
Capital
and
Operations
and
Maintenance
Costs
8
(
iii)
Capital/
Start­
up
vs.
Operations
and
Maintenance
(
O&
M)
Costs
8
(
iv)
Annualizing
Capital
Costs
8
6(
c)
Estimating
Agency
Burden
and
Cost
8
6(
d)
Estimating
the
Respondent
Universe
and
Total
Burden
and
Costs
9
6(
e)
Bottom
Line
Burden
Hours
and
Cost
Tables
9
6(
f)
Reasons
for
Change
in
Burden
10
6(
g)
Burden
Statement
10
List
of
Tables
Table
6­
1
Estimated
Use
of
Generic
ICR
by
Partnership
Programs
Table
6­
2
Estimated
Number
of
Annual
Respondents
Table
6­
3
Estimated
Annual
Respondent
Burden
and
Cost
Table
6­
4
Estimated
Annual
Agency
Burden
and
Cost
Table
6­
5
Total
Estimated
Annual
Burden
Hours
and
Costs
for
Respondents
and
EPA
Table
6­
6
Total
Estimated
Three­
Year
Burden
Hours
and
Costs
for
Respondents
and
EPA
Attachment
A
Questions
for
EPA
Partnership
Programs
1
U.
S.
ENVIRONMENTAL
PROTECTION
AGENCY
ASSESSMENT
OF
EPA
PARTNERSHIP
PROGRAMS
1.
Identification
of
the
Information
Collection
1(
a)
Title
of
the
Information
Collection:
Assessment
of
EPA
Partnership
Programs
1(
b)
Short
Characterization/
Abstract
The
Environmental
Protection
Agency
(
EPA)
is
seeking
approval
for
a
three­
year
generic
clearance
from
the
Office
of
Management
and
Budget
(
OMB)
to
collect
data
to
be
used
for
performance
measurement
of
EPA
Partnership
Programs.

This
will
be
a
voluntary
collection
of
information
to
assess
the
results
arising
from
activities
conducted
by
partners
in
EPA
Partnership
Programs.
The
proposed
generic
measurement
ICR
will
involve
voluntary
collections
of
information
via
surveys
to
assess
the
activities
of
EPA
Partnership
Programs.
Performance
measurement
data
collected
will
detail
awareness
of
associated
environmental
activities,
behavior
change,
and
associated
environmental
benefits.
EPA
proposes
to
use
electronic
surveys
and
questionnaires
to
assess
activities
for
program
purpose
and
design,
strategic
planning,
program
management,
and
program
results
to
determine
if
the
goals
of
the
program
are
being
met.

The
affected
audience
for
this
ICR
includes
participants
in
all
of
EPA's
Partnership
Programs,
including
businesses,
governments,
and
members
of
the
community.

Similar
to
the
OECA
generic
ICR
for
Assessment
of
Compliance
Assistance
Projects
(
EPA
ICR
1869.02),
this
generic
ICR
will
streamline
the
ability
of
the
90+
EPA
Partnership
Programs
to
assess
activities
for
program
purpose
and
design,
strategic
planning,
program
management
and
program
results
to
determine
if
the
goals
of
the
program
are
being
met.
Without
this
generic
measurement
ICR,
each
of
the
90+
programs
must
develop
an
individual
ICR,
submit
it
to
OMB,
and
OMB
must
then
review
and
approve
each
ICR.
The
generic
ICR
will
save
both
time
and
resources.

All
assessments
undertaken
under
this
ICR
will
follow
stringent
procedures
to
ensure
that
data
are
collected
and
used
properly
and
efficiently.
This
ICR
will
provide
anecdotal
data
for
the
purpose
of
informing
EPA
of
the
perceived
effectiveness
of
partnership
programs
and
will
also
allow
partnership
programs
to
collect
data
on
the
environmental
results
of
partner
activities
due
to
participation.
The
information
collection
is
voluntary,
and
will
be
limited
to
non­
sensitive
data
concerning
participation
in
partnership
programs.

This
process
does
not
involve
fact­
finding
for
the
purposes
of
regulatory
development
or
enforcement.

EPA
estimates
that
a
combination
of
surveys
(
electronic,
mail,
and
telephone)
will
generate
voluntary
responses
from
approximately
16,000
respondents
for
an
estimated
burden
of
34,668
hours
over
a
three­
year
period.
EPA
anticipates
that
use
of
this
generic
ICR
will
increase
over
the
course
of
three
years,
and
the
burden
will
grow
each
year.
2
2.
Need
for
and
Use
of
the
Collection
2(
a)
Need/
Authority
for
the
Collection
To
help
fulfill
the
broad
mandate
of
protecting
human
health
and
the
environment,
EPA
works
with
businesses,
communities,
state
and
local
governments,
and
other
organizations
to
achieve
environmental
goals
through
partnership
programs.
Partnership
programs
provide
organizations
with
the
information
and
assistance
necessary
to
achieve
and
maintain
various
environmental
goals.

EPA
believes
that
measuring
the
performance
of
partnership
programs
is
compulsory
to
ensure
that
partnership
programs
are
reaching
the
intended
audience,
providing
valuable
resources,
and
achieving
the
desired
environmental
results.
Understanding
this
will
allow
EPA
to
better
design
and
manage
these
partnership
programs
to
meet
the
needs
of
the
participants
and
to
meet
EPA's
environmental
goals.
A
generic
measurement
ICR
will
significantly
increase
the
ability
of
EPA
Partnership
Programs
to:
obtain
sound
program
performance
data
to
determine
and
evaluate
the
effectiveness
of
these
partnership
programs
as
well
as
help
the
programs
obtain
data
to
successfully
complete
PART
reviews;
increase
the
consistency
of
program
performance
data
as
an
alternative/
adjunct
to
traditional
regulatory
approaches
for
achieving
environmental
results;
minimize
approval
burden
on
OMB
as
submissions
will
be
shorter
and
of
higher
quality
via
the
generic
measurement
ICR
process;
and
reduce
burden
on
potential
respondents
by
limiting
the
number
of
requests
for
information.

2(
b)
Practical
Utility/
Uses
of
the
Data
EPA
believes
program
measurement
is
a
requirement
of
a
well­
managed
program.
The
feedback
will
help
the
Agency:
assess
activities
for
program
purpose
and
design,
strategic
planning,
program
management
and
program
results
to
determine
if
the
goals
of
the
program
are
being
met.

This
ICR
only
supports
program
assessments,
which
describe
accomplishments,
yet
make
no
broad
generalizations
or
claims.
The
ICR
will
not
be
used
to
make
generalizations
to
overall
populations
(
e.
g.,
industry
sectors
or
geographic
regions).
The
ICR
does
not
involve
"
fact­
finding"
for
the
purposes
of
regulatory
development
or
enforcement,
and
the
information
obtained
will
not
be
used
to
make
major
policy
decisions.
Additionally,
no
sensitive
data
will
be
collected
under
this
ICR.

After
the
partnership
programs
collect
data
under
each
survey,
the
responses
will
be
reported
to
OPEI
as
specified
in
section
5(
b).
Following
analysis,
the
synthesized
findings
will
be
shared
with
the
appropriate
Agency
offices,
which
may
use
them
to:


Develop
baseline
data
on
existing
partner
practices
prior
to
participation
in
the
partnership
program.


Perform
program
evaluation
to
increase
program
effectiveness,
including
collecting
ideas
or
suggestions
for
improvement
of
program
services
(
e.
g.,
helplines,
publications)
from
the
people
who
use
them.


Assess
the
current
value
of
a
program
to
participants
for
use
in
future
program
recruiting
materials
and
to
assess
perceived
benefits
of
the
program
compared
with
expenditures.


Identify
topics
on
which
to
develop
additional
resources.


Assess
changes
in
behavior
and
environmental
results
to
inform
EPA
management
and
stakeholders
of
success
and
gauge
program
effectiveness.
3
EPA
anticipates
that
the
results
of
partnership
program
assessments
will
lead
to
increased
participation
in
and
improved
effectiveness
of
the
partnership
programs.
Ultimately,
these
changes
could
result
in
increased
environmental
results
as
the
programs
are
tailored
to
best
meet
the
needs
of
the
participants.

3.
Non­
duplication,
Consultations,
and
Other
Collection
Criteria
3(
a)
Non­
duplication
EPA
will
evaluate
performance
of
partnership
programs,
including
materials
produced,
educational/
outreach
activities,
and
environmental
results
from
partner
participation.
The
information
collected
through
this
ICR
will
not
overlap
with
other
EPA
surveys.

3(
b)
Public
Notice
Required
Prior
to
ICR
Submission
to
OMB
On
[
INSERT
DATE],
EPA
published
a
pre­
ICR
Federal
Register
Notice
announcing
its
intent
to
submit
an
ICR
to
OMB
regarding
the
measurement
of
partnership
programs.
EPA
did
not
receive
any
comments
on
this
ICR.

3(
c)
Consultations
EPA
has
received
feedback
on
this
information
collection
from
key
stakeholders
including:


EPA
Partnership
Program
managers
and
staff
who
could
make
use
of
the
ICR

Managers
of
the
OECA
and
OPEI
customer
service
ICR

EPA's
Evaluation
Support
Division,
which
conducted
a
review
of
the
draft
questions
3(
d)
Effects
of
Less
Frequent
Data
Collection
EPA
anticipates
that
partnership
programs
will
reassess
their
partners'
activities
every
other
year.
In
most
cases,
programs
will
only
reassess
one
time
during
the
three­
year
clearance;
therefore
this
information
collection
could
not
be
conducted
less
frequently.

3(
e)
General
Guidelines
This
ICR
complies
with
OMB's
general
guidelines
for
the
collection
of
information.

3(
f)
Confidentiality
No
confidential
data
will
be
collected.

3(
g)
Sensitive
Questions
No
sensitive
data
will
be
collected.
4
4.
The
Respondents
and
the
Information
Requested
4(
a)
Respondents/
SIC
Codes
For
this
ICR,
the
term
"
respondents"
refers
to
individuals
who
provide
feedback
on
EPA's
Partnership
Programs
and
activities.
Potential
respondents
include
all
partnership
program
participants
including
businesses,
governments,
and
members
of
the
community.

4(
b)
Information
Requested
(
i)
Data
items,
including
record
keeping
requirements
Information
requested
by
surveys
developed
under
this
ICR
will
be
used
to
assess
partnership
programs.
Each
survey
will
request
specific
information
related
to
the
partnership
program
being
evaluated.
EPA
offers
more
than
90
partnership
programs
to
a
wide
range
of
audiences.
Section
1(
b)
identifies
the
general
types
of
questions
that
will
be
asked
in
the
surveys.
Surveys
developed
under
this
ICR
will
be
limited
to
those
types
of
questions.
See
Attachment
A
for
the
list
of
questions.

For
purposes
of
this
generic
ICR,
EPA
assumed
the
following
three
types
of
surveys
will
be
used
to
assess
partnership
programs:


Level
1 
Awareness
Survey:
This
type
of
survey
would
include
general
questions
about
the
participating
organization
and
questions
to
determine
changes
in
awareness
of
environmental
issues
as
a
result
of
participation
in
the
partnership
program.


Level
2 
Awareness
and
Behavior
Survey:
This
type
of
survey
would
include
general
questions
about
the
participating
organization
and
awareness
of
environmental
issues
along
with
questions
to
measure
behavior
change.


Level
3 
Awareness,
Behavior,
and
Environmental
Results
Survey:
This
type
of
survey
would
include
behavioral
change
questions
as
mentioned
above
as
well
as
environmental
results
and
cost
savings
data.
This
survey
would
require
respondents
to
track
and
collect
some
data.

(
ii)
Respondent
activities
As
part
of
this
ICR,
respondents
will
review
survey
forms,
collect
data
as
necessary,
answer
questions,
and
submit
survey
forms
to
EPA.

5.
The
Information
Collected 
Agency
Activities,
Collection
Methodology,
and
Information
Management
5(
a)
Agency
Activities
Agency
activities
associated
with
the
collection
of
information
on
partnership
programs
may
include:


Developing
individual
surveys

Disseminating
questionnaires
to
respondents

Gathering
information
from
respondents

Filtering/
screening
response
data
obtained
through
Internet
feedback
screens
5

Reviewing
data

Preparing
findings

Storing
and
maintaining
results

Adjusting
partnership
program
activities
based
on
assessment
results
5(
b)
Collection
Methodology
and
Management
An
internal
review
and
oversight
process,
independent
of
the
originating
program
office,
has
been
established
for
all
assessment
activities
conducted
under
this
ICR.
Prior
to
initiating
an
assessment,
each
program
will
provide
to
OPEI
a
memo
with
the
following
information:


Title,
identification
of
originator,
and
appropriate
contact
information.


Summary
and
description
of
the
intended
purpose
as
it
relates
to
the
mission
of
EPA's
Partnership
Programs.


Delivery
method
(
e.
g.,
electronic/
mail/
fax,
phone),
collection
schedule,
and
follow
up
plans.


Planned
use
of
information
collected.


Number
of
respondents,
and
burden
in
costs
and
hours
to
respondents
and
the
Agency.

OPEI
will
submit
surveys
to
OMB
for
a
10­
business
day
expedited
review
and
determination.
A
summary
including
title,
sponsoring
office,
number
of
respondents,
and
estimated
burden
hours
and
costs
will
be
attached.
Following
the
completion
of
assessment
activities,
all
offices
will
provide
copies
of
their
approved
assessment
tool,
analytical
reports,
and
a
description
of
any
follow
up
actions
to
OPEI.
The
Agency
will
maximize
the
efficiency
of
information
collection
by
making
every
effort
to
improve
response
rates
to
assessment
activities.

5(
c)
Small
Entity
Flexibility
All
data
collected
under
this
ICR
are
voluntarily
reported.
EPA
expects
that
some
of
the
participants
in
EPA
Partnership
Programs
will
be
small
entities.
EPA
has
designed
this
generic
ICR
to
minimize
respondent
burden
while
obtaining
sufficient
and
accurate
information.

5(
d)
Collection
Schedule
This
will
be
dependent
upon
the
needs
of
each
originator
of
a
survey.
Schedules
for
surveys
will
be
documented
by
the
survey
sponsors.

6.
Estimating
the
Burden
and
Cost
of
the
Collection
6(
a)
Estimating
Respondent
Burden
Respondent
activities
are
expected
to
include
only
a
few
steps:
reviewing
instructions,
responding
to
surveys,
and
sending
(
via
mail,
e­
mail,
or
telephone)
responses.
To
minimize
the
respondent
burden,
EPA
will
use
simple,
clear
survey
designs
that
are
easy
to
respond
to
and
are
of
limited
scope.
There
will
be
no
requirement
for
respondents
to
develop
data
gathering
systems,
train
personnel,
or
maintain
records.
However,
respondents
might
need
to
collect
and
track
some
data.

EPA
expects
the
burden
associated
with
this
ICR
to
grow
over
the
course
of
three
years.
This
is
due
to
several
reasons.
First,
many
partnership
programs
have
existing
ICRs
in
place
and
may
not
need
to
6
use
the
generic
ICR
until
they
are
due
for
renewal.
Second,
as
EPA
Partnership
Program
staff
become
more
familiar
with
the
generic
ICR,
OPEI
anticipates
that
more
programs
will
begin
using
it.
Table
6­
1
below
presents
the
estimated
use
of
this
generic
ICR
by
partnership
programs
over
the
course
of
three
years.
Over
the
course
of
these
three
years,
participants
in
those
partnership
programs
will
be
asked
to
submit
information.

Table
6­
1
Estimated
Use
of
Generic
ICR
by
Partnership
Programs
Year
1
10
programs
Year
2
25
programs
Year
3
35
programs
To
determine
the
total
number
of
respondents,
EPA
assumed
that
its
smaller
partnership
programs
(
with
200
or
fewer
participants)
would
be
most
likely
to
use
the
generic
ICR.
Based
on
that
assumption,
EPA
anticipates
the
number
of
respondents
listed
in
table
6­
2.
In
the
first
year,
EPA
estimates
feedback
from
approximately
2,000
respondents
for
an
estimated
burden
of
4,333
hours.
In
the
second
year,
EPA
estimates
feedback
from
approximately
5,000
respondents
for
an
estimated
burden
of
10,833
hours.
In
the
third
year,
EPA
estimates
feedback
from
approximately
9,000
respondents
for
an
estimated
burden
of
19,500
hours.
In
addition,
those
partnership
programs
that
will
use
the
generic
ICR
in
year
1
will
most
likely
reassess
participant
activities
in
year
3.

Table
6­
2
Estimated
Number
of
Annual
Respondents
Year
1
2,000
respondents
Year
2
5,000
respondents
Year
3
9,000
respondents
Total
16,000
respondents
Table
6­
3
presented
below,
present
the
annual
respondent
burden
and
cost
estimates.
These
estimates
are
based
on
OPEI's
knowledge
of
surveys
conducted
under
various
partnership
programs'
ICRs
and
experience
with
similar
performance
measurement
surveys
used
under
OECA's
generic
ICR
for
Compliance
Assistance
Measurement
(
EPA
ICR
1869.02).

Using
a
list
of
pre­
determined
questions
(
Attachment
A),
partnership
programs
are
able
to
select
the
questions
they
are
interested
in
using.
There
are
different
types
of
questions
geared
at
gauging
awareness,
behavior
change,
and
measurement
of
partnership
programs.
Partnership
programs
using
the
generic
ICR
may
select
from
these
questions
to
design
a
tailored
questionnaire
for
their
specific
needs.
Partnership
programs
will
also
have
the
option
of
customizing
the
answer
choices
for
the
questions
they
choose
to
use.

Table
6­
3
presents
the
total
annual
estimated
respondent
burden
and
cost
for
each
information
collection
activity,
broken
down
by
survey
type.
7
Table
6­
3
Estimated
Annual
Respondent
Burden
and
Cost
Information
Collection
Activity
Hours
and
Costs
Per
Respondent
Total
Hours
and
Costs
Manager
Technical
Clerical
Respond
Hours/
Year
Labor
Costs
per
Year
No.
of
Respond./
Activities
Total
Respond.
Hours/
Year
Total
Cost/
Year
Hourly
Rate
79.49
64.80
34.86
Awareness
Survey
Review
survey
form
0.1
0.1
$
6
1777.8
178
$
11,520
Answer
general
questions
to
measure
awareness
0.3
0.3
$
19
1777.8
533
$
34,560
Submit
form
0.1
0.1
$
6
1777.8
178
$
11,520
Subtotal
0.5
0.5
$
32
889
$
57,601
Awareness
and
Behavior
Survey
Review
survey
form
0.1
0.1
$
6
1777.8
178
$
11,520
Answer
questions
to
measure
awareness/
behavior
change
0.5
0.5
$
32
1777.8
889
$
57,601
Management
review
0.3
0.3
$
24
1777.8
533
$
42,395
Submit
form
0.1
0.1
$
6
1777.8
178
$
11,520
Subtotal
0.3
0.7
0
1
$
69
1,778
$
123,036
Awareness,
Behavior,
and
Environmental
Results
Survey
Review
survey
form
0.1
0.1
$
6
1777.8
178
$
11,520
Collect
data
for
environmental
results
3.8
3.8
$
246
1777.8
6,756
$
437,765
Answer
questions
to
measure
awareness/
behavior
change
and
to
illustrate
environmental
results
0.5
0.5
$
32
1777.8
889
$
57,601
Management
review
0.5
0.5
$
40
1777.8
889
$
70,659
Submit
form
0.1
0.1
$
6
1777.8
178
$
11,520
Subtotal
0.5
4.5
0
5.0
$
331
8,889
$
589,065
TOTAL
0.8
5.7
0
6.6
439.432
11,556
$
769,702
6(
b)
Estimating
Respondent
Costs
In
order
to
minimize
the
respondent
burden,
survey
designs
will
be
simple,
convenient,
easy
to
respond
to,
and
clear
in
content
and
purpose.
Surveys
will
be
of
limited
scope
and
require
only
a
short
time
to
complete.

(
i)
Estimating
Labor
Costs
The
labor
rates
used
to
determine
the
estimated
costs
to
respondents
are
consistent
with
the
hourly
wage
rates
published
by
the
Bureau
of
Labor
Statistics
publications
on
employment
and
earnings.
Rates
include
the
cost
of
overhead
and
fringe
benefits.
EPA
estimates
an
average
respondent
hourly
labor
rate
(
hourly
plus
overhead)
of
$
79.49
for
managerial
staff,
$
64.80
for
technical
staff,
and
$
34.86
for
clerical
staff.
8
(
ii)
Estimating
Capital
and
Operations
and
Maintenance
Costs
Activities
supported
by
this
ICR
do
not
involve
the
purchase
of
monitoring
or
reporting
equipment.

(
iii)
Capital/
Start­
up
Operating
and
Maintenance
(
O
&
M)
Costs
Activities
supported
by
this
ICR
do
not
involve
the
purchase
of
monitoring
or
reporting
equipment.

(
iv)
Annualizing
Capital
Costs
Not
applicable.

6(
c)
Estimating
Agency
Burden
and
Cost
Table
6­
4
provides
the
annual
estimates
for
EPA
burden
and
cost
associated
with
developing
and
disseminating
surveys
and
analyzing
the
results.
EPA
used
its
experience
implementing
other
partnership
programs
to
estimate
burden
estimates
for
Agency
staff.
The
hourly
labor
rates
used
to
determine
the
estimated
costs
to
the
Agency
are
consistent
with
annual
labor
rates
published
in
the
Federal
Register
and
are
based
on
the
2004
GS
pay
schedule
available
from
the
Office
of
Personnel
Management.
EPA
estimates
an
average
hourly
labor
cost
of
$
62.91
for
managerial
staff;
$
46.11
for
technical
staff;
and
$
18.51
for
clerical
staff.
The
labor
costs
are
based
on
the
following
GS
levels
and
steps:
managerial
rates
were
based
on
GS
Level
14,
Step
4;
technical
labor
rates
were
based
on
GS
Level
12
Step
5;
and
clerical
labor
rates
were
based
on
GS
Level
5,
Step
1.
To
derive
hourly
estimates,
EPA
divided
annual
compensation
by
2,080 
the
number
of
hours
in
the
Federal
work­
year.
EPA
then
multiplied
hourly
rates
by
the
standard
government
overhead
factor
of
1.6.

Because
EPA
expects
use
of
the
generic
ICR
to
increase
over
the
course
of
3
years,
in
order
to
determine
the
Agency's
annual
burden,
EPA
assumed
an
average
of
23.3
programs
using
the
generic
ICR
each
year,
with
those
surveys
being
evenly
divided
between
the
three
types
of
surveys.
9
Table
6­
4
Estimated
Annual
Agency
Burden
and
Cost
Information
Collection
Activity
Hours
and
Costs
Per
Respondent
Total
Hours
and
Costs
Manager
Technical
Clerical
Agency
Hours/
Year
Labor
Costs
per
Year
No.
of
Events
Total
Agency
Hours/
Year
Total
Cost/
Year
Hourly
Rate
62.91
46.11
18.51
Awareness
Survey
Choose
survey
questions
and
response
selections
and
develop
forms
0.5
4
0.5
5
$
225
7.7
38.5
$
1,734
Distribute
forms
1
1
2
$
65
7.7
15.4
$
498
Answer
questions
from
respondents
2
2
$
92
7.7
15.4
$
710
Review
completed
submissions
and
enter
into
database,
as
necessary
8
2
10
$
406
7.7
77
$
3,125
Perform
quality
control
1
4
5
$
247
7.7
39
$
1,905
Subtotal
1.5
19
3.5
24
$
1,035
185
$
7,971
Awareness
and
Behavior
Survey
Choose
survey
questions
and
response
selections
and
develop
forms
0.5
6
0.5
7
$
317
7.7
54
$
2,444
Distribute
forms
1
1
2
$
65
7.7
15
$
498
Answer
questions
from
respondents
3
3
$
138
7.7
23
$
1,065
Review
completed
submissions
and
enter
into
database,
as
necessary
10
2
12
$
498
7.7
92
$
3,836
Perform
quality
control
1
4
5
$
247
7.7
39
$
1,905
Subtotal
1.5
24
3.5
29
$
1,266
223
$
9,747
Awareness,
Behavior,
and
Environmental
Results
Survey
Choose
survey
questions
and
response
selections
and
develop
forms
1
8
1
10
$
450
7.7
77
$
3,467
Distribute
forms
1
1
2
$
65
7.7
15
$
498
Answer
questions
from
respondents
4
4
$
184
7.7
31
$
1,420
Review
completed
submissions
and
enter
into
database,
as
necessary
12
4
16
$
627
7.7
123
$
4,831
Perform
quality
control
1
5
6
$
293
7.7
46
$
2,260
Subtotal
1
30
6
38
$
1,327
293
$
12,475
TOTAL
4
73
13
91
3627.75
700.7
$
30,193.32
6(
d)
Estimating
the
Respondent
Universe
and
Total
Burden
and
Costs
EPA
estimates
that
over
the
three­
year
life
of
the
umbrella
clearance,
16,000
respondents
will
voluntarily
respond
to
partnership
program
assessments
conducted
under
this
ICR
for
a
total
burden
of
34,668
hours
and
a
total
cost
of
$
2,309,106.

6(
e)
Bottom
Line
Burden
Hours
and
Cost
Tables
Table
6­
5
summarizes
the
total
estimated
annual
burden
hours
and
costs
for
respondents
and
for
the
Agency.
The
total
annual
cost
for
respondents
is
$
769,702
and
the
hourly
burden
is
approximately
11,556.
The
total
annual
cost
for
the
Agency
is
$
30,193
and
the
hourly
burden
is
approximately
701.
Table
6­
5
displays
these
combined
estimates,
as
well
as
the
grand
total
of
$
799,895
and
the
hourly
burden
10
of
12,257
hours
for
all
information
collection
activities
under
this
generic
ICR.

Table
6­
5
Total
Estimated
Annual
Burden
Hours
and
Costs
for
Respondents
and
EPA
Burden
Hours/
Year
Total
Labor
Costs/
Year
Total
Capital
Costs/
Year
Total
Cost/
Year
Respondents
11,556
$
769,702
$
0
$
769,702
EPA
701
$
30,193
$
0
$
30,193
TOTAL
12,257
$
799,895
$
0
$
799,895
Table
6­
6
summarizes
the
total
estimated
three­
year
burden
hours
and
costs
for
respondents
and
for
the
Agency.
The
total
three­
year
cost
for
respondents
is
$
2,309,106
and
the
hourly
burden
is
approximately
34,668.
The
total
three­
year
cost
for
the
Agency
is
$
90,579
and
the
hourly
burden
is
approximately
2,103.

Table
6­
6
Total
Estimated
Three
Year
Burden
Hours
and
Costs
for
Respondents
and
EPA
Burden
Hours
Total
Labor
Costs/
Year
Total
Capital
Costs/
Year
Total
Cost
Respondents
34,668
$
2,309,106
$
0
$
2,309,106
EPA
2,103
$
90,579
$
0
$
90,579
TOTAL
36,771
$
2,399,685
$
0
$
2,399,685
6(
f)
Reasons
for
Change
in
Burden
This
ICR
does
not
modify
an
existing
ICR.

6(
g)
Burden
Statement
The
estimated
average
annual
respondent
reporting
and
recordkeeping
burden
for
this
collection
of
information
is
2.2
hours.
Burden
means
the
total
time,
effort,
or
financial
resources
expended
by
persons
to
generate,
maintain,
retain,
or
disclose
or
provide
information
to
or
for
a
Federal
Agency.
This
includes
the
time
needed
to
review
instructions;
develop,
acquire,
install,
and
utilize
technology
and
systems
for
the
purposes
of
collecting,
validating,
and
verifying
information;
adjust
the
existing
ways
to
comply
with
any
previously
applicable
instructions;
search
data
sources;
complete
and
review
the
collection
of
information;
and
transmit
or
otherwise
disclose
the
information.
An
agency
may
not
conduct
or
sponsor,
and
a
person
is
not
required
to
respond
to,
a
collection
of
information
unless
it
displays
a
currently
valid
OMB
control
number.
The
OMB
control
numbers
for
EPA's
regulations
are
listed
in
40
CFR
Part
9
and
48
CFR
Chapter
15.

To
comment
on
the
Agency's
need
for
this
information,
the
accuracy
of
the
provided
burden
estimates,
and
any
suggested
methods
for
minimizing
respondent
burden,
including
the
use
of
automated
collection
techniques,
EPA
has
established
a
public
docket
for
this
ICR
under
Docket
ID
No.
EPA­
HQOA
2006­
0566,
which
is
available
for
public
viewing
at
the
OEI
Docket
in
the
EPA
Docket
Center
(
EPA/
DC),
EPA
West,
Room
B102,
1301
Constitution
Ave.,
NW,
Washington,
DC.
The
EPA
Docket
Center
Public
Reading
Room
is
open
from
8:
30
a.
m.
to
4:
30
p.
m.,
Monday
through
Friday,
excluding
legal
holidays.
The
telephone
number
for
the
Reading
Room
is
(
202)
566­
1744,
and
the
telephone
number
for
the
OEI
Docket
is
(
202)
566­
1752.
Use
www.
regulations.
gov
to
obtain
a
copy
of
the
draft
collection
11
of
information,
submit
or
view
public
comments,
access
the
index
listing
of
the
contents
of
the
docket,
and
to
access
those
documents
in
the
public
docket
that
are
available
electronically.
Once
in
the
system,
select
"
search,"
then
key
in
the
docket
ID
number
identified
in
this
document.
1
Attachment
A
Questions
for
EPA
Partnership
Programs
1.
Please
indicate
the
total
number
of
employees
(
members)
at
your
facility/
organization:
__________

OR
circle
the
range
of
number
of
employees
that
fits
closest:

1­
50
51­
100
101­
500
501­
1000
1,001­
5,000
5,000
+

2.
Which
of
the
following
best
describes
your
organization?

_____
Business
or
Industry
(
Please
include
SIC
or
NAICS
code,
if
available)

_____
Government
_____
Non­
profit/
Non­
Governmental
Organization
_____
Other
3.
What
is
your
position
in
your
organization?
Check
the
one
that
best
represents
your
primary
focus
area.

_____
Environmental,
health,
and
safety
_____
Information
technology
_____
Management
_____
Contractor
_____
Production
_____
Sales/
Marketing
_____
Finance
_____
Other
(
please
specify):
_________________________________________

4.
How
did
you
first
learn
about
(
name
of
partnership
program)?

_____
Industry
partner
_____
Web
site
_____
Brochure
Directions:
Partnership
Programs
using
the
generic
ICR
may
select
from
these
questions
to
design
a
tailored
questionnaire
for
their
specific
needs.
Regarding
the
questions
listed
below,
bolded
questions
will
not
change.
However,
answer
choices
(
a,
b,
c,
d,
etc.)
and
examples
can
be
tailored
to
the
requirements
of
a
specific
Partnership
Program.
2
_____
Conference/
Meeting
_____
Other
_____
N/
A
5.
How
important
to
you
were
the
following
reasons
for
joining
(
name
of
partnership
program)?
(
1=
not
important
to
7=
very
important.)

Examples:
_____
a.
General
information
about
<
insert
name
of
environmental
problem
addressed
by
program>.

_____
b.
To
learn
about
pollution
prevention
opportunities.

_____
c.
To
receive
EPA
recognition
for
our
efforts.

_____
d.
To
network
with
other
organizations.

_____
e.
To
improve
public
or
industry
perception
of
our
organization.

_____
f.
To
identify
cost
savings
opportunities.

_____
g.
To
obtain
technical
assistance
from
EPA.

_____
h.
To
improve
environmental
performance
_____
i.
Other
(
Please
specify.)
___________________

6.
Overall,
how
valuable
do
you
find
your
participation
in
(
name
of
partnership
program)
on
a
scale
of
1
to
7
with
7
being
the
most
valuable.
Do
you
find
participation
in
the
(
name
of
the
partnership
program)
to
be
worth
the
time
and
cost
expended?

Value:
_______
Because
_________________________________________________________________

7.
How
would
you
rate
your
understanding
of
the
following
issues
before
your
participation
in
(
name
of
partnership
program)?
(
1=
no
understanding;
7=
highest
level
of
understanding)
Select
DK
if
you
don't
know
or
N/
A
for
not
applicable.

Examples:

a.
Issue
1
______

b.
Issue
2
______

8.
How
would
you
rate
your
understanding
of
the
following
issues
after
your
participation
in
(
name
of
partnership
program)?
(
1=
no
understanding;
7=
highest
level
of
understanding).
Select
DK
if
you
don't
know
or
N/
A
for
not
applicable.

Examples:

a.
Issue
1
_______

b.
Issue
2
_______
3
9.
How
helpful
are
the
following
elements
of
the
(
name
of
partnership
program)?
Please
rate
from
1
to
7
with
7
being
the
most
helpful.

(
Select
DK
if
you
don't
know
or
N/
A
for
not
applicable.)

Examples:

Web
site
______
Electronic
reporting
system
______
Written
program
materials
______
Program
implementation
guide
______
Introductory
program
brochure
______
Technical
assistance
______
Networking
opportunities
______
EPA
recognition
______
Staff
knowledge
______
Staff
responsiveness
______
Other
(
please
specify):
_______________________________________________________________________

How
could
these
elements
be
improved?
_____________________________________________________

10.
Please
rate
your
preference
for
receiving
information
related
to
(
name
of
partnership
program)
(
1=
preferred
method,
7=
not
preferred)
(
Select
DK
if
you
don't
know
or
N/
A
for
not
applicable.)

Examples:
_____
Manuals
(
comprehensive)

_____
E­
mail
_____
Phone
_____
Fact
Sheets
(
short,
single
topic)

_____
Newsletter
or
journal
articles
_____
CDs
_____
Web
sites
_____
Workshops
_____
Videos
_____
Other
(
please
specify):_________________________________________
4
11.
What
internal
activities
has
your
organization
conducted
as
a
result
of
your
participation
in
(
name
of
partnership
program)
[
Insert
time
period]?
(
Check
all
that
apply.)
(
You
will
have
the
opportunity
to
quantify
cost
savings
and
environmental
results
associated
with
these
activities
in
Questions
14­
21
below).

Examples:
______
a.
Food
grown
under
integrated
pest
management
(
IPM),
organic,
or
other
environmentally­
friendly
food
labeling
programs
______
b.
Adoption
of
IPM
and
other
environmental
stewardship
practices
______
c.
Promoted
integrative
vegetative
management
(
IVM)
techniques
______
d.
Other
(
please
specify):
_______________________________________

______
e.
Don't
Know
______
f.
Not
Applicable
12.
What
management
changes,
if
any,
at
your
facility/
organization
did
you
take
as
a
result
of
your
participation
in
(
name
of
partnership
program)
[
Insert
time
period]?
(
Check
all
that
apply.)

Examples:
_____
a.
Conducted
a
self
audit
_____
b.
Established
an
environmental
management
system
_____
c.
Instituted
training
or
other
communication
to
improve
awareness
and/
or
practices
_____
d.
Developed
a
"
green
team"

_____
e.
Took
no
management
action
_____
f.
Other
(
please
specify):
______________________________________________________

______
g.
Don't
Know
_____
h.
Not
Applicable
13.
What
external
activities
did
you
conduct
as
a
result
of
your
participation
in
(
name
of
partnership
program)
[
Insert
time
period]?

(
Check
all
that
apply.)

Examples:
_____
a.
Referred
the
program
to
customers,
industry
colleagues,
or
suppliers
_____
b.
Publicized
participation
in
the
program
to
the
community
and
other
stakeholders
_____
c.
Encouraged
parent/
sister
organizations
to
participate
in
the
program
_____
d.
Issued
new
requirements
to
suppliers
(
e.
g.,
participation
in
the
program,
change
of
specifications)

_____
e.
No
external
activities
will
be
conducted
_____
f.
Other
(
please
specify):________________________________________________

______
g.
Don't
Know
_____
h.
Not
Applicable
5
14.
What
have
been
other
benefits,
if
any,
for
your
facility/
organization
participating
in
(
name
of
partnership
program)?
(
Check
all
that
apply.)
Examples:

_____
a.
Improved
quality
of
products
_____
b.
Improved
worker
health
and
safety
_____
c.
Increased
employee
satisfaction/
morale
_____
d.
Public
recognition
_____
e.
Access
to
resources
and
technical
assistance
_____
f.
Improved
efficiency
(
e.
g.,
less
waste,
better
processes,
etc.)

_____
g.
Other:
______________

_____
h.
No
benefit
15.
Please
describe
the
environmental
benefits
of
any
GREEN
DESIGN
changes
undertaken
[
Insert
time
period]
as
part
of
your
participation
in
(
name
of
partnership
program):

Activity
Amount
Before
Design
Change
Amount
After
Design
Change
Total
Change
Number
of
Units
Planned
for
Production
(
e.
g.,
Redesigned
product
to
eliminate
lead
and
mercury)
_____
Mercury
per
unit
_____
Other
_____
Don't
Know
_____
Mercury
per
unit
_____
Other
_____
Don't
Know
_____
Mercury
per
unit
_____
Other
_____
Don't
Know
_____
Units
_____
Other
16.
Please
identify
any
change
in
GREEN
PURCHASES
(
or
sales)
as
a
result
of
participation
in
(
name
of
partnership
program)
[
Insert
time
period].
If
available,
please
provide
the
amount
of
change:

Activity
Amount
Before
Implementing
Activity
Amount
After
Implementing
Activity
Total
Change
(
e.
g.,
Began
using
green
power
for
25%
of
operations)
_____
Megawatts
OR
____
BTUs
of
green
energy
______
Dollars
spent
on
environmentallypreferable
products
______
Certified
water
efficient
products
______
Biopesticides
______
Organic
or
slow­
release
fertilizers
_____
Megawatts
OR
____
BTUs
of
green
energy
______
Dollars
spent
on
environmentallypreferable
products
______
Certified
water
efficient
products
______
Biopesticides
______
Organic
or
slow­
release
fertilizers
_____
Megawatts
OR
____
BTUs
of
green
energy
______
Dollars
spent
on
environmentallypreferable
products
______
Certified
water
efficient
products
______
Biopesticides
______
Organic
or
slow­
release
fertilizers
6
______
Other:__________________

_____
Don't
Know
______
Other:_________________

_____
Don't
Know
______
Other:___________________

_____
Don't
Know
If
other
factors
aside
from
the
actions
taken
impacted
these
results
(
e.
g.,
production
decreased
by
50
percent,
change
in
total
sales
occurred,
or
change
in
number
of
employees
occurred),
please
indicate
that
here.
___________________________________________________________________________________________________________

17.
Please
identify
any
change
in
RAW
MATERIALS,
process
input
supplies,
and
feedstocks
that
resulted,
from
the
actions
taken
[
Insert
time
period]
as
a
result
of
participation
in
(
the
partnership
program).
If
available,
please
provide
the
amount
of
the
changes).

Activity
Amount
of
Feedstock
Used
Before
Implementing
Activity
Amount
of
Feedstock
Used
After
Implementing
Activity
Total
Change
(
e.
g.,
Lightweighted
primary
packaging)

Capital
Costs
________

Cost
Savings
________

(
if
known)
_____
pounds
of
hazardous
materials
or
toxic
chemicals
(
chemical
name______)

_____
pounds
of
non­
hazardous
materials
(
e.
g.,
packaging)
(
type
of
material:
e.
g.,

paper,
plastic,
glass_______________)

_____
Other:___________________

_____
Don't
Know
_____
pounds
of
hazardous
materials
or
toxic
chemicals
(
chemical
name______)

_____
pounds
of
non­
hazardous
materials
(
type
of
material:
e.
g.,
paper,

plastic_______________)

_____
Other:___________________

_____
Don't
Know
_____
pounds
hazardous
material
or
toxic
chemicals
______
pounds
of
non­
hazardous
materials
(
type
of
material:
e.
g.,
paper,

plastic_______________)

_____
Other:___________________

_____
Don't
Know
If
other
factors
aside
from
the
actions
taken
impacted
these
results
(
e.
g.,
production
decreased
by
50
percent,
change
in
total
sales
occurred,
or
change
in
number
of
employees
occurred),
please
indicate
that
here.

___________________________________________________________

Please
briefly
describe
how
you
measured
these
results
(
e.
g.,
compared
utility
bills
and
after
implementation)
____________________

If
you
provided
cost
savings,
how
were
the
savings
calculated
(
e.
g.,
avoided
purchasing
costs,
avoided
labor
costs)

_______________________
7
18.
Please
identify
any
change
in
NATURAL
RESOURCE
use
that
resulted
from
the
actions
taken
[
Insert
time
period]
as
a
result
of
participation
in
(
the
partnership
program)
If
available,
please
provide
the
amount
of
the
reduction(
s):

Activity
Amount
Natural
Resource
Used
Before
Implementing
Activity
Amount
of
Natural
Resource
Used
After
Implementing
Activity
Total
Change
(
e.
g.,
Installed
highefficiency
bathroom
fixtures)

Capital
Costs
________

Cost
Savings
________

(
if
known)
_____
gallons
of
water
_____
megawatts
OR
____
BTUs
of
energy
_____
gallons
of
fuel
_____
organic
material
_____
Other:___________________

_____
Don't
Know
_____
gallons
of
water
_____
megawatts
OR
____
BTUs
of
energy
_____
gallons
of
fuel
_____
organic
material
_____
Other:___________________

_____
Don't
Know
_____
gallons
of
water
conserved
_____
megawatts
OR
____
BTUs
of
energy
_____
gallons
of
fuel
_____
organic
material
_____
Other:___________________

_____
Don't
Know
_____
gallons
of
water
_____
megawatts
OR
____
BTUs
of
energy
_____
gallons
of
fuel
_____
organic
material
_____
Other:___________________

_____
Don't
Know
_____
gallons
of
water
_____
megawatts
OR
____
BTUs
of
energy
_____
gallons
of
fuel
_____
organic
material
_____
Other:___________________

_____
Don't
Know
_____
gallons
of
water
conserved
_____
megawatts
OR
____
BTUs
of
energy
_____
gallons
of
fuel
_____
organic
material
_____
Other:___________________

_____
Don't
Know
If
other
factors
aside
from
the
actions
taken
impacted
these
results
(
e.
g.,
production
decreased
by
50
percent,
change
in
total
sales
occurred,
or
change
in
number
of
employees
occurred),
please
indicate
that
here.

___________________________________________________________

Please
briefly
describe
how
you
measured
these
results
(
e.
g.,
compared
utility
bills
and
after
implementation)
____________________

If
you
provided
cost
savings,
how
were
the
savings
calculated
(
e.
g.,
avoided
purchasing
costs,
avoided
labor
costs)

_______________________
8
19.
Please
identify
any
change
in
a
POLLUTANT(
S)
EMISSIONS
OR
WASTE
that
resulted
from
the
actions
taken
[
Insert
time
period]

as
a
result
of
participation
in
(
the
partnership
program).
If
available,
please
provide
the
amount
of
the
reduction(
s):

Activity
Amount
of
Pollution
or
Waste
Generated
Before
Implementing
Activity
Amount
of
Pollution
or
Waste
Generated
After
Implementing
Activity
Total
Change
(
e.
g.,
Change
to
low­

VOC
coating
operations)

Capital
Costs
________

Cost
Savings
_______

(
if
known)
_____
pounds
of
solid
waste
_____
pounds
of
hazardous
waste
_____
pounds
of
air
emissions
_____
pounds
of
NOx
_____
pounds
of
water
pollutants/
nitrogen
_____
pounds/
gallons
of
chemicals
_____
Other:___________________

_____
Don't
Know
_____
pounds
of
solid
waste
_____
pounds
of
hazardous
waste
_____
pounds
of
air
emissions
_____
pounds
of
NOx
_____
pounds
of
water
pollutants/
nitrogen
_____
pounds/
gallons
of
chemicals
_____
Other:___________________

_____
Don't
Know
_____
pounds
of
solid
waste
_____
pounds
of
hazardous
waste
_____
pounds
of
air
emissions
_____
pounds
of
NOx
_____
pounds
of
water
pollutants/
nitrogen
_____
pounds/
gallons
of
chemicals
_____
Other:___________________

_____
Don't
Know
_____
pounds
of
solid
waste
_____
pounds
of
hazardous
waste
_____
pounds
of
air
emissions
_____
pounds
of
NOx
_____
pounds
of
water
pollutants/
nitrogen
_____
pounds/
gallons
of
chemicals
_____
Other:___________________

_____
Don't
Know
_____
pounds
of
solid
waste
_____
pounds
of
hazardous
waste
_____
pounds
of
air
emissions
_____
pounds
of
NOx
_____
pounds
of
water
pollutants/
nitrogen
_____
pounds/
gallons
of
chemicals
_____
Other:___________________

_____
Don't
Know
_____
pounds
of
solid
waste
_____
pounds
of
hazardous
waste
_____
pounds
of
air
emissions
_____
pounds
of
NOx
_____
pounds
of
water
pollutants/
nitrogen
_____
pounds/
gallons
of
chemicals
_____
Other:___________________

_____
Don't
Know
If
other
factors
aside
from
the
actions
taken
impacted
these
results
(
e.
g.,
production
decreased
by
50
percent,
change
in
total
sales
occurred,
or
change
in
number
of
employees
occurred),
please
indicate
that
here.
_____________________________________________________________________________________________________________________

___
Please
briefly
describe
how
you
measured
these
results
(
e.
g.,
Compared
disposal
volume
provided
by
hauler
before
and
after
implementation
9
If
you
provided
cost
savings,
how
were
the
savings
calculated
(
e.
g.,
avoided
disposal
costs)

20.
Please
identify
amount
of
materials
REUSED
that
resulted
from
actions
taken
[
Insert
time
period]
as
a
result
of
participation
in
(
the
partnership
program).
If
available,
please
provide
the
amount
reused:

Activity
Amount
of
Material
Reused
Before
Implementing
Activity
Amount
of
Material
Reused
After
Implementing
Activity
Total
Amount
Reused
(
e.
g.,
Donated
computers
for
reuse
by
schools,

reused
water
for
landscaping)

Capital
Costs_________

Cost
Savings
________

(
if
known)
_____
computer
monitors
_____
computer
CPUs
_____
laptop
computers
_____
printers
_____
cell
phones
_____
pounds
of
paper
_____
pounds
of
glass
_____
pounds
of
plastic
_____
pounds
of
organic
material
_____
gallons
of
fuel
_____
gallons
of
water
_____
Other
______
Don't
Know
_____
computer
monitors
_____
computer
CPUs
_____
laptop
computers
_____
printers
_____
cell
phones
_____
pounds
of
paper
_____
pounds
of
glass
_____
pounds
of
plastic
_____
pounds
of
organic
material
_____
gallons
of
fuel
_____
gallons
of
water
_____
Other
______
Don't
Know
_____
computer
monitors
_____
computer
CPUs
_____
laptop
computers
_____
printers
_____
cell
phones
_____
pounds
of
paper
_____
pounds
of
glass
_____
pounds
of
plastic
_____
pounds
of
organic
material
_____
gallons
of
fuel
_____
gallons
of
water
_____
Other
______
Don't
Know
If
other
factors
aside
from
the
actions
taken
impacted
these
results
(
e.
g.,
production
decreased
by
50
percent,
change
in
total
sales
occurred,
or
change
in
number
of
employees
occurred),
please
indicate
that
here.
____________________________________________________________________________________________________________________

Please
briefly
describe
how
you
measured
these
results
(
e.
g.,
Compared
disposal
volume
provided
by
hauler
before
and
after
implementation
10
If
you
provided
cost
savings,
how
were
the
savings
calculated
(
e.
g.,
avoided
disposal
costs)
_____________________________________________________________________________________________________________

21.
Please
identify
amount
of
materials
RECYCLED
that
resulted
from
actions
taken
[
Insert
time
period]
as
a
result
of
participation
in
(
the
partnership
program).
If
available,
please
provide
the
amount
recycled:

Activity
Amount
of
Material
Recycled
Before
Implementing
Activity
Amount
of
Material
Recycled
After
Implementing
Activity
Total
Amount
Recycled
(
e.
g.,
Computers
sent
to
recycling
facilities,
cans
donated
to
school
groups
for
recycling)

Capital
Costs
_______

Cost
Savings
_______

(
if
known)
_____
computer
monitors
_____
computer
CPUs
_____
laptop
computers
_____
printers
_____
cell
phones
_____
pounds
of
paper
_____
pounds
of
glass
_____
pounds
of
aluminum
_____
pounds
of
plastic
_____
pounds
of
organic
material
_____
gallons
of
fuel
_____
gallons
of
water
_____
Other
_____
Don't
Know
_____
computer
monitors
_____
computer
CPUs
_____
laptop
computers
_____
printers
_____
cell
phones
_____
pounds
of
paper
_____
pounds
of
glass
_____
pounds
of
aluminum
_____
pounds
of
plastic
_____
pounds
of
organic
material
_____
gallons
of
fuel
_____
gallons
of
water
_____
Other
_____
Don't
Know
_____
computer
monitors
_____
computer
CPUs
_____
laptop
computers
_____
printers
_____
cell
phones
_____
pounds
of
paper
_____
pounds
of
glass
_____
pounds
of
aluminum
_____
pounds
of
plastic
_____
pounds
of
organic
material
_____
gallons
of
fuel
_____
gallons
of
water
_____
Other
______
Don't
Know
If
other
factors
aside
from
the
actions
taken
impacted
these
results
(
e.
g.,
production
decreased
by
50
percent,
change
in
total
sales
occurred,
or
change
in
number
of
employees
occurred),
please
indicate
that
here.
_____________________________________________________________________________________________________________________

Please
briefly
describe
how
you
measured
these
results
(
e.
g.,
Compared
disposal
volume
provided
by
hauler
before
and
after
implementation
If
you
provided
cost
savings,
how
were
the
savings
calculated
(
e.
g.,
avoided
disposal
costs)
__________________________________________________________________________________________________________
11
22.
Please
describe
any
other
additional
environmental
benefits
[
Insert
time
period]
(
not
already
captured
above)
achieved
by
your
organization
as
a
result
of
participation
in
the
partnership
program
(
e.
g.,
wildlife
benefits,
greenhouse
gas
reductions,
reduced
school
absences
attributed
to
pesticide
exposure):__________________________________________________________________________________________________________
