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
U.
S.
EPA,
Office
of
Administration
and
Resources
Management,
Office
of
Acquisition
Management
2.
OMB
control
number
b.
x
None
a_
2_
0
3_
0_
­
__
__
__
__
__
__
__
__

3.
Type
of
information
collection
(
check
one)
a.
X
New
collection
b.
°
Revision
of
a
currently
approved
collection
c.
°
Extension
of
a
currently
approved
collection
d.
°
Reinstatement,
without
change,
of
a
previously
approved
collection
for
which
approval
has
expired
e.
°
Reinstatement,
with
change,
of
a
previously
approved
collection
for
which
approval
has
expired
f.
°
Existing
collection
in
use
without
an
OMB
control
number
4.
Type
of
review
requested
(
check
one)
a.
X
Regular
b.
°
Emergency
­
Approval
requested
by:
/
/
c.
°
Delegated
5.
Small
entities
Will
this
information
collection
have
a
significant
economic
impact
on
a
substantial
number
of
small
entities?
°
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.°
Other
Specify:
/
/___

7.
Title
BACKGROUND
CHECKS
FOR
CONTRACTORS
PERFORMING
SERVICES
ON­
SITE
FOR
THE
ENVIRONMENTAL
PROTECTION
AGENCY
8.
Agency
form
number(
s)
(
If
applicable)
ICR
No.
2102.01
9.
Keywords
Procurement,
Government
10.
Abstract
The
Office
of
Acquisition
Management
of
the
Environmental
Protection
Agency
use
contractors
to
perform
services
on
or
within
federally­
owned
or
leased
facilities,
commercial
space
primarily
occupied
by
federal
employees
and
Superfund,
Oil
Pollution
Act,
and
Stafford
Act
sites.
All
contractor
employees
who
will
perform
work
onsite
are
subject
to
a
background
investigation
prior
to
their
entry
on­
site.
The
Contractor
is
responsible
for
conducting
the
background
investigation
and
for
screening
unacceptable
candidates
from
the
proposed
pool
of
on­
site
workers.
The
background
investigation
must
have
been
performed
within
the
30
calendar
day
period
prior
to
the
proposed
on­
site
entry
date.
The
Contractor
shall
maintain
records
associated
with
all
background
investigations
11.
Affected
public
(
Mark
primary
with
"
P"
and
all
others
that
apply
with
"
X")
a.
Individuals
or
households
d.
Farms
b.
P
Business
or
other
for­
profit
e.
Federal
Government
c.
X
Not­
for­
profit
institutions
f.
State,
Local
or
Tribal
Government
12.
Obligation
to
respond
(
Mark
primary
with
"
P"
and
all
others
that
apply
with
"
X")
a.
°
Voluntary
b.
X
Required
to
obtain
or
retain
benefits
c.
P
Mandatory
13.
Annual
reporting
and
recordkeeping
hour
burden
a.
Number
of
respondents
1
b.
Total
annual
responses
1
1.
Percentage
of
these
responses
collected
electronically
0
%
c.
Total
hours
requested
1
d.
Current
OMB
inventory
0
e.
Difference
1
f.
Explanation
of
difference
1.
Program
Change
1
2.
Adjustment
0
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.
__
Application
for
benefits
e.
Program
planning
or
management
b.
__
Program
evaluation
f.
Research
c.
__
General
purpose
statistics
g.
P
Regulatory
or
compliance
d.
__
Audit
16.
Frequency
of
recordkeeping
or
reporting
(
check
all
that
apply)
a.
X
Recordkeeping
b.
°
Third
party
disclosure
c.
X
Reporting
1.
X
On
occasion
2.
°
Weekly
3.
°
Monthly
4.
°
Quarterly
5.
°
Semi­
annually
6.
°
Annually
7.
°
Biannually
8.
°
Other
(
describe)

17.
Statistical
methods
Does
this
information
collection
employ
statistical
methods?
Yes
X
No
18.
Agency
contact
(
person
who
can
best
answer
questions
regarding
the
content
of
this
submission)
Name:
Daniel
Humphries
Phone:
(
202)
564­
4377
OMB
83­
I
10/
95
19.
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.

.

Signature
of
Program
Official
Ronald
L.
Kovach,
Director
Policy,
Training
and
Oversight
Division
Office
of
Acquisition
Management
Date
Signature
of
Senior
Official
or
designee
Oscar
Morales,
Director
Collection
Strategies
Division
Office
of
Environmental
Information
Date
OMB
83­
I
10/
95
