PAPERWORK REDUCTION ACT SUBMISSION WORKSHEET

PART I: Information Collection Request

This worksheet replaces the previous OMB 83-I form for Information
Collection Requests (ICRs).  This worksheet is intended to help ICR
preparers transition between the paper 83-I system and use of the
Information Collection Request, Review and Approval System (ICRAS) for
submitting ICRs to OMB.  This form is not intended for submission to
OMB.  For additional guidance on completing this worksheet, please see
EPA’s ICR website at   HYPERLINK "http://intranet.epa.gov/icrintra/" 
http://intranet.epa.gov/icrintra/ .  There you will find the following
documents: OEI’s ICRAS Instructions (under Prepare ICR Package tab)
and OMB’s ROCIS IC Q&A (located under the Download Guidance tab), as
well as the contact information for your appropriate ICR desk officer.

1. Agency/Subagency originating request:   FORMTEXT  OAR/OAQPS/SPPD     

2. Title:   FORMTEXT  NESHAP for Area Sources: Acrylic And Modacrylic
Fibers Production, Carbon Black Production, Chemical Manufacturing:
Chromium Compounds, Flexible Polyurethane Foam Productionand
Fabrication, Lead Acid Battery Manufacturing, and Wood Preserving 

3. Type of Information Collection (check one):

  FORMCHECKBOX    New collection

  FORMCHECKBOX    Extension of a currently approved collection

  FORMCHECKBOX    Revision of a currently approved collection

  FORMCHECKBOX    Nonmaterial or non-substantive change to a currently
approved collection 

      (formerly called the 83-C)	4. OMB Control Number (OCN):   FORMTEXT
            

     EPA ICR Number:   FORMTEXT  2256.01 



5. Type of review requested (check one):

  FORMCHECKBOX    Regular

  FORMCHECKBOX    Emergency – Approval Requested by:   FORMTEXT 
       (mm/dd/yy)

  FORMCHECKBOX    Delegated

(If emergency, please submit justification as a separate attachment)	6.
Requested expiration date (check one):

  FORMCHECKBOX    Three years from approval date

  FORMCHECKBOX    Six Months from approval date (maximum for emergency)

       (mm/yy)

7. Abstract (4000 characters maximum, attach additional sheets as
necessary):   FORMTEXT  EPA is issuing six national emission standards
for hazardous air pollutants (NESHAP) for seven area source categories.
The requirements for two area source categories (Flexible Polyurethane
Foam Production and Flexible Polyurethane Foam Fabrication) are combined
in one subpart. The final standards include emissions limitations and
work practice requirements for new and existing plants based on the
generally available control technology or management practices  (GACT)
for each area source category. Potential respondents include one
existing acrylic and modacrylic production facility, no existing carbon
black area sources, two existing chromium product manufacturing
facilities, 500 existing flexible polyurethane foam production and
fabrication facilities, 60 existing lead acid battery manufacturing
facilities, and 393 existing wood preserving facilities. The total
annual responses attributable to this ICR for existing sources are two
one-time notifications; some existing facilities may be required to
prepare a startup, shutdown, and malfunction plan and/or conduct an
initial performance test. The owner or operator of a new area source
would be required to comply with all requirements of the General
Provisions (40 CFR part 63, subpart A). No burden estimates are provided
for new  area sources because no new facilities are expected during the
next 3 years. 



8.  Citations for Authorizing Statute(s):

 a.   FORMCHECKBOX    Public Law

           Name of law:   FORMTEXT  Clean Air Act 

           Citation:    FORMTEXT  42 USC    -    FORMTEXT  7401 et seq  
Sec    FORMTEXT  112 

 b.   FORMCHECKBOX    US Code      

           Name of Law:   FORMTEXT  Clean Air Act                       

           Citation:    FORMTEXT  42  USC:   FORMTEXT  7401 et seq  

 c.   FORMCHECKBOX    Executive Order

           Name/Subject of EO:   FORMTEXT        

           Citation:  EO    FORMTEXT        

    

d.   FORMCHECKBOX    Statute at Large

           Name of Statute:   FORMTEXT        

           Citation:    FORMTEXT          Stat    FORMTEXT 
      

9. Associated Rulemaking Information (For Rule Related ICRs Only):

  RIN:    FORMTEXT  2060  –   FORMTEXT  AN44                          
      SAN:   FORMTEXT  5012                                             
          Stage of Rulemaking (check one):                              
                     

                                                                        
                                                                    
FORMCHECKBOX    Proposed Rule	                                        

                                                                        
                                                                    
FORMCHECKBOX    Interim Final or Final Rule		                

                                                                        
  

For a Proposed Rule, OMB will not consider an ICR complete until the
Notice of Proposed Rulemaking has been published.  OEI will enter this
information into ICRAS.

For ICRs associated with Interim Finals that are not significant under
EO 12866, please attach a draft of the rule.

10. Federal Register Notices & Comments:

Federal Register Citation (For Non-Rule Related and Renewal ICRs Only):

60-day Notice:    Volume:   FORMTEXT            Page number:  
FORMTEXT            Publication Date:   FORMTEXT 
      	            

(30-day Notice:    Volume:             Page number:              
Publication Date  	  	 )		

Did the Agency receive public comments on this ICR?     FORMCHECKBOX  
Yes    FORMCHECKBOX   No

Unless submitted as an Emergency ICR or Associated with a Rulemaking,
OMB will not consider an ICR complete until the 30-day notice

has been published.  The second notice will be published following OEI
review and approval of the ICR. OEI will enter this information into
ICRAS.

11. Annual Cost to Federal Government:      FORMTEXT  47099.00 

12.  Does this ICR contain surveys, censuses, or employ statistical
methods?      FORMCHECKBOX    Yes      FORMCHECKBOX    No

(If Yes, please attach Supporting Statement, Part B)

13. Is a Privacy Impact Assessment required by the E-Government Act of
2002 for this ICR?      FORMCHECKBOX    Yes      FORMCHECKBOX    No

(A PIA is needed for a new, electronic collection of information.)

14. Agency Contact:

      

       Name:    FORMTEXT  Sharon Nizich 

     

       Phone:   FORMTEXT  919.541.2825 

     

       E-mail:   FORMTEXT  nizich.sharon@epa.gov 



15. Change in Burden:

  

A.  Program Change Due to a New Statute

If change in burden is a Program Change Due to a New Statute, identify
the Citations for the New Statutory Requirements:

a.   FORMCHECKBOX    Public Law

      

           Citation:    FORMTEXT          -    FORMTEXT 
        Sec    FORMTEXT        

 b.   FORMCHECKBOX    US Code      

           Name of Law:   FORMTEXT                            
 

           Citation:    FORMTEXT         USC:   FORMTEXT 
       

 c.   FORMCHECKBOX    Executive Order

           Name/Subject of EO:   FORMTEXT        

           Citation:  EO    FORMTEXT        

    

d.   FORMCHECKBOX    Statute at Large

  Name of Statute:   FORMTEXT        

  Citation:    FORMTEXT          Stat    FORMTEXT 
      

B. Program Change Due to Agency Discretion

If change in burden is a  DECREASE because of a Program Change due to
Agency Discretion, please categorize the decrease (select one):

  FORMCHECKBOX    Cutting Redundancy

  FORMCHECKBOX    Using Information Technology

  FORMCHECKBOX    Changing Regulations

  FORMCHECKBOX    Changing Forms

  FORMCHECKBOX    Miscellaneous Actions

If change in burden is a  INCREASE because of a Program Change due to
Agency Discretion, please categorize the increase (select one):

           FORMCHECKBOX   Changing Regulations 

           FORMCHECKBOX   Miscellaneous Actions 

C. Explanation of Change in Burden

Explain the reasons for any program changes or adjustments reported;
that is, provide a short statement addressing how the reduction in
burden was achieved or why the increase in burden occurred. (If you need
more space, provide a short summary here and elaborate in the Supporting
Statement.)

  FORMTEXT        

PAPERWORK REDUCTION ACT SUBMISSION WORKSHEET

Part III: Information Collection Request Completeness Check 

Complete this checklist prior to submitting the information collection
package to the Clearance Officer.  The Clearance Officer will use the
information contained in this checklist, along with other information,
to certify the information collection prior to submission to OMB.  

The supporting statement (check all that apply):

  FORMCHECKBOX    Identifies the statute or regulation authorizing the
collection of the information

  FORMCHECKBOX    Describes efforts taken to avoid the collection of
similar information already available, or collected under a different
information collection

  FORMCHECKBOX    Describes, if applicable, methods to minimize the
burden on small businesses or other small entities

  FORMCHECKBOX    Is written using plain English, and all terminology
used is unambiguous and understandable to those required to respond to
the collection

  FORMCHECKBOX    Indicates how long records specified in the collection
are to be maintained by persons required to maintain the records

  FORMCHECKBOX    Has dedicated resources to ensure the proper use and
processing of the information being collected to enhance (as
appropriate) the value of the information to agencies and the public.

  FORMCHECKBOX    Indicates the use of a statistical survey method (if
applicable) that produces valid and reliable results while minimizing
undue burden.

  FORMCHECKBOX    Describes the intended use of information technology
to reduce burden and where possible avoid unnecessary system and
technology costs.





PAPERWORK REDUCTION ACT SUBMISSION WORKSHEET

Part IV: Certification

Certification for Paperwork Reduction Act Submissions

On behalf of this Federal agency, 1 certify that the collection of
information encompassed by this request complies with'

5 CFR 1320.9.

NOTE: 	The text of 5 CFR 1320.9, and the related provisions of 5 CFR
1320.8(b)(3), appear at the end of the instructions.  The certification
is to be made with reference to those regulatory provisions as set forth
in the instructions.	

The following is a summary of the topics, regarding the proposed
collection of information, that the certification covers:

	(a)  It is necessary for the proper performance of agency functions;

	(b)  It avoids unnecessary duplication;

	(c)  It reduces burden on small entities;

	(d)  It uses plain, coherent, and unambiguous terminology that is
understandable to respondents;

	(e)  Its implementation will be consistent and compatible with current
reporting and recordkeeping practices;

	(f)  It indicates the retention periods for recordkeeping requirements;

	(g)  It informs respondents of the information called for under 5 CFR
1320.8(b)(3):

		(I)  Why the information is being collected’

		(ii)  Use of information;

		(iii)  Burden estimate;

		(iv)  Nature of response (voluntary, required for a benefit, or
mandatory);

		(v)   Nature and extent of confidentiality; and

		(vi)  Need to display currently valid OMB control number;

	(h)  It was developed by an office that has planned and allocated
resources for the efficient and effective management 

                          and use of the information to be collected
(see note in Item 19 of the instructions);

	(I)  It uses effective and efficient statistical survey methodology;
and

	(j)  It makes appropriate use of information technology.



Signature of Program Official

      

  FORMTEXT        

  FORMTEXT        	Date



  SEQ CHAPTER \h \r 1 Signature of Senior Official or designee          
                                         

Oscar Morales, Director 

                                                                        
                         Collection Strategies  Division

                                                                        
             Office of Environmental Information	Date





5 CFR 1320.9 reads “As part of the agency submission to OMB of a
proposed collection of information, the agency (through the head of the
agency, the Senior Official or their designee) shall certify (and
provide a record supporting such certification) that the proposed
collection of information --

     “(a) is necessary for the proper performance of the functions of
the agency, including that the information to be collected will have
practical utility;

     “(b) is not unnecessarily duplicative of information otherwise
reasonably accessible to the agency;

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en on persons who shall provide information to or for the agency,
including with respect to small entities, as defined in the Regulatory
Flexibility Act 5 U.S.C § 601(6)), the use of such techniques as:

“(1) establishing differing compliance or reporting requirements or
timetables that take into account the resources available to those who
are to respond;

“(2) the clarification, consolidation, or simplification of compliance
and reporting requirements; or collection of information , or any part
thereof;

“(3) an exemption from coverage of the collection of information, or
any part thereof;

      “(d) is written using plain, coherent, and unambiguous
terminology and is understandable to those who are to respond;

      “(e) is to be implemented in ways consistent and compatible, to
the maximum extent practicable, with the existing reporting and
recordkeeping practices of those who are to respond;

       “(f) indicates for each recordkeeping requirement the length of
time persons are required to maintain the records specified;

       “(g) informs potential respondents of the information called
for under § 1320.8(b)(3); [see below]

       “(h) has been developed by an office that has planned and
allocated resources for the efficient and effective management and use
of the information to be collected, including the processing of  the
information in a manner  which shall enhance, where appropriate, the
utility of the information to agencies and the public;

       “(I)  uses effective and efficient statistical survey
methodology appropriate to the purpose for which the information is to
be collected; and

       “(j) to the maximum extent practicable, uses appropriate
information technology to reduce burden and improve data quality, agency
efficiency and responsiveness to the public.”

NOTE: 5 CFR 1320.8(b)(3) requires that each collection of information:

        “(3) informs and provides reasonable notice to the potential
persons to whom the collection of information is addressed of:

“(I) the reasons the information is planned to be and/or has been used
to further the proper performance of the functions of  the agency;

“(ii) the way such information is planned to be and/or has been used
to further the proper performance of  the functions of the agency;

“(iii) an estimate, to the extent practicable, of  the average burden
of  the collection (together  with a request that the public direct to
the agency any comments concerning the accuracy of  this burden estimate
and any suggestions for reducing this burden);

“(iv) whether responses to the collection of information are
voluntary, required to obtain or retain a benefit (citing authority), or
mandatory (citing authority);

	“(v) the nature and extent of confidentiality to be provided, if any
(citing authority); and

“(vi) the fact that any 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.”





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Revised 1/30/2007

