PAPERWORK
REDUCTION
ACT
SUBMISSION
Please
read
the
instructions
before
completing
this
form.
For
additional
forms
or
assistance
in
completing
this
form,
contact
your
agency's
Paperwork
Clearance
Officer.
Send
two
copies
of
this
form,
the
collection
instrument
to
be
reviewed,
the
Supporting
Statement
and
any
additional
documentation
to:
Office
of
Information
and
Regulatory
Affairs,
Office
of
Management
and
Budget,
Docket
Library,
Room
10102,
725
17th
Street
NW
Washington,
DC
20503.

1.
Agency/
Subagency
originating
request
EPA\
Office
of
Air
and
Radiation\
Imitate
Office
2.
OMB
control
number
b.
G
None
a
2060
­
0306
__
__
__
__

3.
Type
of
information
collection
(
check
one)
a.
G
New
collection
b.
G
Revision
of
a
currently
approved
collection
c.
X
Extension
of
a
currently
approved
collection
d.
G
Reinstatement,
without
change,
of
a
previously
approved
collection
for
which
approval
has
expired
e.
G
Reinstatement,
with
change,
of
a
previously
approved
collection
for
which
approval
has
expired
f.
G
Existing
collection
in
use
without
an
OMB
control
number
4.
Type
of
review
requested
(
check
one)
a.
X
Regular
b.
G
Emergency
­
Approval
requested
by:
/
/
c.
G
Delegated
5.
Small
entities
Will
this
information
collection
have
a
significant
economic
impact
on
a
substantial
number
of
small
entities?
G
Yes
X
No
For
b­
f,
note
item
A2
of
Supporting
Statement
Instructions
6.
Requested
expiration
date
a.
X
Three
years
from
approval
date
b.
G
Other
Specify:
/
/___

7.
Title
Clean
Air
Act
Tribal
Authority
8.
Agency
form
number(
s)
(
If
applicable)
ICR#:
1676.03
9.
Keywords
Tribal
Authority,
Clean
Air
Act,
eligibility
determination,
burden
hours,
costs,
air
pollution,
environmental
protection
10.
Abstract
This
ICR
requests
clearance
of
EPA's
review
and
approval
process
for
determining
Tribe
eligibility
to
carry
out
the
Clean
Air
(
CAA).
Tribes
may
choose
to
submit
a
CAA
eligibility
determination
and
a
CAA
program
application
to
EPA
at
the
same
time
for
approval
and
EPA
will
review
both
submittals
simultaneously.
EPA
will
use
this
information
to
determine
if
a
Tribe
meets
the
statutory
criteria
under
section
301(
d)
of
the
CAA
and
is
qualified
for
purposes
of
implementing
an
Air
Quality
Program.
Section
114
of
the
CAA
is
the
authority
for
the
collection
of
information.

11.
Affected
public
(
Mark
primary
with
"
P"
and
all
others
that
apply
with
"
X")
a.
Individuals
or
households
d.
Farms
b.
Business
or
other
for­
profit
e.
Federal
Government
c.
Not­
for­
profit
institutions
f.
X
State,
Local
or
Tribal
Government
12.
Obligation
to
respond
(
Mark
primary
with
"
P"
and
all
others
that
apply
with
"
X")
a.
X
Voluntary
b.
G
Required
to
obtain
or
retain
benefits
c.
G
Mandatory
13.
Annual
reporting
and
recordkeeping
hour
burden
a.
Number
of
respondents
22
b.
Total
annual
responses
7
1.
Percentage
of
these
responses
collected
electronically
0
%
c.
Total
hours
requested
293
d.
Current
OMB
inventory
480
e.
Difference
­
187
f.
Explanation
of
difference
1.
Program
Change
0
2.
Adjustment
­
187
14.
Annual
reporting
and
recordkeeping
cost
burden
(
in
thousands
of
dollars)

a.
Total
annualized
capital/
startup
costs
0
b.
Total
annual
costs
(
O&
M)
0
c.
Total
annualized
cost
requested
0
d.
Current
OMB
inventory
0
e.
Difference
0
f.
Explanation
of
difference
1.
Program
change
0
2.
Adjustment
0
15.
Purpose
of
information
collection
(
Mark
Primary
With
"
P"
and
all
others
that
apply
with
"
X")
a.
_
X_
Application
for
benefits
e.
__
Program
planning
or
management
b.
__
Program
evaluation
f.
__
Research
c.
__
General
purpose
statistics
g.
X
Regulatory
or
compliance
d.
__
Audit
16.
Frequency
of
recordkeeping
or
reporting
(
check
all
that
apply)
a.
Q
Recordkeeping
b.
Q
Third
party
disclosure
c.
Q
Reporting
1.
Q
On
occasion
2.
Q
Weekly
3.
Q
Monthly
4.
Q
Quarterly
5.
Q
Semi­
annually
6.
Q
Annually
7.
Q
Biannually
8.
X
Other
(
describe)
One
time
application
17.
Statistical
methods
Does
this
information
collection
employ
statistical
methods?

Q
Yes
X
No
18.
Agency
contact
(
person
who
can
best
answer
questions
regarding
the
content
of
this
submission)
Name:
Tony
Bynum
Phone:
202­
564­
1389
OMB
83­
I
10/
95
