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Request for OMB Review & Supporting Statement Re Application Permit for Use of TWFN Auditorium.Estimated Respondent Burden 1 H
	ML20140J567
Person / Time
Issue date:	05/08/1997
From:	Levin A; NRC
To:	;
References
	OMB-3150-0181, OMB-3150-181, NUDOCS 9705140131
	Download: ML20140J567 (10)
	v • d • e

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PAPERWORK REDUCTION ACT SUBMISSION Please read the instructons before completing this form. For additonal forms or assistance in completing th'a 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 10102,72517th Street NW, Washington, DC 20503

1. Agency / Subagency originating request ._.1 OMB control number _

U.S. Nuclear Regulatory Commission X a- 3150 - 0181 b. None J Type of information collection (check one) 4 Type of review requested (check one)

a. New collection X a. Regular submission c. Delegated X b. Revision of a currently approved collection b. Emergency Approvalrequested by(date):

c Extension of a currently approved conection

5. Will ttws information coNection have a y" economic impact on a

d. Reinstatement, without change, of a previously approved substantial number of small entities? X b.No collecbon for which approved has expired

e. Reinstatement, with change a previously appmved X a. Three years from approval date conection for which approval expered

6. ,R date

f. Existing collection in use witnout an OMB control number b. Other(Specify):

7. Title Application / Permit for Use of the Two White Flint North (TWFN) Auditorium, NRC f orm 590

8. Agency form number (s) (#eppfcable)

NRC Form 590

9. Keywords Permit, auditorium, public access, government property

10. Abstract NRC Form 590 is used to allow NRC Facility Management and Secun'ty branch personnel to approve public access to the Two White Flint North Auditorium. They need the form to allow for administrative and security review, to facilitate scheduling and to make a determination that there are no anticipated problems with the requester prior to utilization of the facility.

11, Affected public (Wet pnmey we Fem _r a# omers met oppsy we T) 12. Obhgation to respond (part pruney we F emt e# omers met oppsy we r) l

a. Individuah or households d. Farms a. Voluntary P

b. Required to obtain or retain benefits j

b. Business or other for-pront

{ e. Federal Government c. Mandatory X c. Not-for$rofit institutions X f. State, Local, or Tribal Govemment P

13. Annual reporting and recordkeeping hour burden 14. Annual reporting and recordkeeping cost burden (m mousemis of doners) 5 a. Totalannualized capitaustartup costs 0

a. Number of respondents 5 b. Totalannualcosts(o&M) 0

b. Tceal annual rssponses -

1. Percentage of these resps.nses c. Total annualized cost requested O ccaacted alactroamal'Y 0 ejr, d. Current OMB Inventory o i e. Difference o

c. Total annual hours requested 12 f. Explanation of difference

d. Current OW inventory

1. Program change

e. Difference (11)

2. Adjustment

r. Explanation of delforence

1. Program change

2. Adjustment (11)

15. Purpose of information conection 16. Frequency of recordkeeping or reporting Check all that apply)

(Mark primary with P"and a# others that appfy with T) a. Recordkeeping b. Third-party disclosure

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a. Apphcation fa benefits P e. Program plannmg or managernent T c. ReportinD

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f. Research X 1. On occasion 2.Weeldy 3. Monthh

b. Program ovaluation

c. General purpose statstics g. Regulatory or comphance 4. Quarterty 5. Semi-ennually 6. Annually

7. Biennially 8. Other (describe)

18. 1cy can best answer quesflor's repartfr g the

17. Statistical rnethods Does this information collection employ stat'stical methods? l Name: Dennis M. Tarner '

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b Yes h No 9705140131 970500 ine.' (301) 415-2283 PDR ORG EUSOMB 1 m phM4Villll 'Ill{H}

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19. Certification for Paperwork Reduction Act Submissions On behalf of this Federal agency, I 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 setforth 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 ofinformation; (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 oflice 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.

If you are unable to certify compliance with any of these provisions, identify the item below and explain the reason in Item 18 of the Supporting Statement.

Signature of Senior Official or designee Date L d G JL : '

TNMJ 10/95 OM881i

OMB SUPPORTING STATEMENT FOR NRC FORM 590 APPLICATION / PERMIT FOR USE OF THE TWO WHITE FLINT NORTH (TWFN)

AUDITORIUM (3150-0181)

Description of the Information Collection The U. S. Nuclear Regulatory Commission (NRC) has an auditorium that is available for public use. In accordance with the Public Buildings Act of 1959, an agreement was reached between the Maryland-National Capital Park and Planning Commission (MPPC), the General Services Administration (GSA), and the NRC, which states that the auditorium will be made available for public use. Members of the public who wish to use the auditorium must complete NRC Form 590, " Application / Permit for Use of Two White Flint North (TWFN)

Auditorium," which must be approved prior to public use of the facility.

The form requests identifying information about the requesting applicant / organization, purpose of use, certification for solicitation of funds, documentation of authority to represent an organization, acknowledgement of liability for damages, and a checklist of service needs and allows for administrative and security reviews and final apprnval for use of the facility.

A. JUSTIFICATION

1. Need for and Practical Utility of the Collection of Information. The NRC Form 590, " Application / Permit for Use of Two White Flint North (TWFN) Auditorium," is reviewed by the Facility Management personnel and by the Division of Security.

The information is needed to allow for administrative and security review, facilitate scheduling, and to make a determination that there are no anticipated problems with the requester prior to utilization of the facility.

2. Aaency Use of Information. The NRC uses the information to evaluate requests to use the auditorium.

3. Reduction of Burden throuah Information Technoloav. There are no legal obstacles to reducing the burden associated with this information collection.

4. Effort to identify Duplication and Use Similar Information. The NRC Form 590 is unique to NRC in that it supports an agreement between the NRC, GSA and i MPPC that the auditorium will be made available for public use. The Information !

Requirements Control Automated System (IRCAS) was searched and no l duplication was found. Information to be provided by the public-user is not l otherwise available. I l

5. Effort to Reduce Small Business Burden. The collection represents the minimum information required to assess and approve a member of the public's request to l use a govemment facility. The burden cannot be further reduced.

6. Consecuences to Federal Proaram or Policy Activities if the Collection Is Not Conducted or is Conducted Less Freauently.

The frequency of collection is "as the facility is needed by the requester."

Therefore, this is the minimum frequency that the information can be requested.

If the information is not collected, the public will not have access to the NRC auditorium.

7. Circumstances Which Justify Variation frcm OMB Guidelines. Not applicable.

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8. Consultations Outside the NRC. A notice requesting comments on the information collection was published in the Federal Reaister on December 20, 1996 (61 FR 67351). NRC received no comments.

9. Payment or Gift to Responden.tji. Not applicable.

10. Confidentiality of the information. NRC provides no pledge of confidentiality for this collection of information. To the extent information is business confidential, j procedures are in place to protect the information from improper disclosure.

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11. Justification for SensRive Questions. Normally sensitive information considered priva.e or personal is not required or requested.

12. Estimated Burden and Burden Hour Cost. The total annual public burden for 4

completing NRC Form 590 is 1.25 hours2.893519e-4 days 0.00694 hours 4.133598e-5 weeks 9.5125e-6 months at a cost of $156.25. The annual burden and cost estimates were derived from experience during the past three years with the number of public users' requests to use the facility and the approximate numbe. of hours each requester would have to expend to complete the form (5 requesters x .25/hr. per request = 1.25 hours2.893519e-4 days 0.00694 hours 4.133598e-5 weeks 9.5125e-6 months x $125/ hour = $156.25).

13. Estimate of Other Additional Costs. None.

14. Estimated Annualized Cost to the Federal Government. The cost to the agency for processing the NRC Form 590 was derived from experience during the past three years with facility management and security personnel evaluating and approving public user requests. Facility management and security personnel would expend an average of 1 hour1.157407e-5 days 2.777778e-4 hours 1.653439e-6 weeks 3.805e-7 months to review each request for a total cost to the j agency of 625 (5 requests X 1 hour1.157407e-5 days 2.777778e-4 hours 1.653439e-6 weeks 3.805e-7 months X $125/hr). The cost is recovered by the facility rental fee.

4 l 15. Reason for Chanoes in Burden or Cost. The annual burden estimate is being reduced from 48 to 1.25 hours2.893519e-4 days 0.00694 hours 4.133598e-5 weeks 9.5125e-6 months annually based upon the number of forms received during the past three years.

16. Publication for Statistical Use. Results will not be tabulated or published.

17. Reason for Not Displavina the Expiration Date. The expiration date is displayed.

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18. Exceptions to the Certification Statement. N/A.

B. COLLECTION OF INFORMATION EMPLOYING STATISTICAL METHODS N/A.

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l CHECK LIST OF SERVICE NEEDS FOR PUBLIC-USE SPACE AUDITORlUM (Checkitemsneeded) CATERING KITCHEN MICROPHONE WILL FOOD OR DRINK BE SERVED DURING PROGRAM HOURS? YES NO PODIUM lt is the user's responsibility to assure that the kitchen is clean and !

DIAS CONFIGURATION lNRC]USE ONLYBELOW TH'IS LINE'.0 SCHEDULE OF HOURLY COSTS FOR SERVICES All piogramS are after NRC normal hours of operation. The following iS a Schedule of hourly costs for Services. l FEE SCHEDULE FEE FROM A.M. P.M. TO A.M. P.M COST l

1 HOUR OR FRACTION OF 1 HOUR 2 HOURS OR 1 HOUR AND $335 FRACTION OF SECOND HOUR I

3 HOURS OR 2 HOURS AND FRACTION OF THIRD HOUR 4 HOURS OR LONGER $135 / HOUR TOTAL ADMINISTRATIVE REVIEW APPROVED DISAPPROVED IF DISAPPROVED, REASON FOR DISAPPROVAL l REVIEWING OFFICIAL (Typed a prmisd name einf artie) SIGNATURE DATE SECURITY REVIEW 1

APPROVED DISAPPROVED

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REVtEWING OFFICLAL (Typad a pmled name and 6tle) SIGNATURE DATE 1

PERMIT FOR USE OF THE TWO WHITE FLINT NORTH AUDITORIUM i

l APPROVED BASED UPON ADM NISTRATIVE AND SECURITY REVIEWS, THIS APPLICATION IS DISAPPROVED APPROVING OFFICIAL (Typed a pnnled name end bue) SIGNATURE DATE PRINTED ON RECYCLED PAPER NRC FOHM SGO (MM-YY)

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i U. F$ NUCLEAR REGULATORY CCMMISSION APPROVED BY OMS: NO. 315M191 EXPIRES: OSf31tt r J

NRG FORM 90 (MM/YY)

Eshmated burden per response to comply with this informabon collection This informabon is requested by NRC to de' ermine the request

.ccepomy 15 mm, utesand a schedui,n and so- needed F

= use, rd i APPLICATIONIPERMIT FOR USE OF THE -m-nM re.ordine *-en -bma io a annaboa mad Roc-a Management Branch (T.6 F33) u S. Nuclear Regulatory Commrssion.

i w h'astoa. oC 20sss.oooi. .nd io ine Pa,e,.o,= Reduct,on P,o,eci TWO WHITE FLINT NORTH (TWFN) AUDITORIUM (315o4181). Orhce of Management and Budget, Washington. DC 20503 NRC may not conduct or sponsor, and a person es not required to respond to, 4

a collecbon of enformation uniese it displays a cunently valid OMB control number INSTRUCTIONS: Please submit with this application a copy, sample, or description of any material or item (s) proposed for distribution or dispisy.

Complete the check list of service needs for public-use space on the reverse of this form. Failure to complete this form will result in denitt of a permit.

i IMPORTANT: If the applicant proposes to represent an organization, a letter or other documentation that the applicant has authority to represent that 2 organization must be submitte1 with thts form.

FROM (MM/ dor,'") HOUR AM TO (MM/DOfYY) HOUR AM

1. PROPOSED PM PM DATE(S) i 2 NAME OF APPLICANT (Ferst MeddW Wtial, Lasy TELEPHONE NUMBER (include Area Code) ,

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d A.DORESS (Street, SustafApt No , Cay. Stme. ZIP Code) 4 i

I 3 NAME OF PERSON OR ORoANIZATION SPONSORING, PROMOllNG, OR CONOUCTING THE PROPOSED ACTMTV TELEPHONE NUMBER (include Area Code)

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ADDRESS (Street. Suite / Art No., City. State, ZIP Code) 4 NAME OF PERSON (S) WHO WILL SUPERVISE /BE RESPONSIBLE FOR THE PROPOSED AC11VITY TELEPHONE NUMBER (include Area Code)

ADDRESS (Street, Sutta / Apt No., City. State, ZIP Code) 5 DESCRIPTION OF PROPOSED ACTIVITY d

s. CERTIFICATION AN APPLICANT PROPOSING TO ENGAGE IN THE SOLICITATION OF FUNDS MUST CHECK ONE OF THE FOLLOWING STATEMENTk I CERTIFY THAT:

I represent and wm be soliciting funds for the sole benefit of a religion or religious group, My organization has received an official Internal Revenue Service (IRS) ruling or letter of determination stating that the organization or its parent organization qualifies for tax-exempt status under 26 U.S.C. 501(c)(3), (c)(4), or (c)(5).

My organization has apphed to the IRS for a determination of tax-exempt status under 26 U.S.C. 501(c)(3), (c)(4), or (c)(5), and that the IRS has not yet issued a final administrative ruling or determination of such status.

I certify that I am authorized to sign this apphcation on behalf of the named organtration. I have read and fully comprehend all fees, rules, and regulations contained in the pohcies and procedures associated with the use of the Two White Flint North Auditorium. I fully accept liability for any damages that may occur during the scheduled use or any additional charges that may result from the designated use of the auditorium.

SIGNATURE - APPLICANT DATE NRC FORM 59o (MM-YY) PRINTED ON RECYCLED PAPER

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[7590-01-P]

1 i U. S. NUCLEAR REGULATORY COMMISSION :

Agency Information Collection Activities: Submission for OMB Review; Comment 4

Request J

AGENCY: U. S. Nuclear Regulatory Commission (NRC) i 1

4 ACTION: Notice of the OMB review of information collection and solicitation of public comment. p ;

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SUMMARY

The NRC has recently submitted to OMB for review the following proposal for ,

1 the collection of information unde:r the provisions of the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35). The NRC hereby informs potential respondents that an agency may not conduct or sponsor, and that a person is not required to ;

respond to, a collection of information unless it displays a currently valid OMB j control number.

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1. Type of submission, new, revision, extension: Revision

2. The title of the information collection: Application / Permit for Use of the i

- Two White Flint (TWFN) Auditorium 4

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l I 3. The form number if applicable: NRC Form 590 l

4. How often the collection is required: Each time public use of the auditorium is requested.

5. Who will be required or asked to report: Member of the public requesting use of the NRC Auditorium.

6. An estimate of the number oi:..aiu?! responses: 5

7. The estimate of the number of annual respondents: 5

8. An estimate of the total number of hours needed annually to complete the requirement or request: 1.25 hours2.893519e-4 days 0.00694 hours 4.133598e-5 weeks 9.5125e-6 months (15 minutes per request).

9. An indication of whether Section 3507(d). Pub. L.104-13 applies: N/A.

10. Abstract: In accordance with the Public Buildings Act of 1959, an agreement was reached between the Maryland-National Capital Park and Planning Commission (MPPC), the General Services Administration (GSA) and the Nuclear Regulatory Commission, the NRC auditorium will will be made available for public use. Public users of the auditorium will be required to complete NRC Form 590, Application / Permit for Use of Two White Flint North (TWFN) Auditorium.

The information is needed to allow for administrative and security review, scheduling, and to make a determinauv . that there are no

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l anticipated problems with the requester prior to utilization of the facility, j i

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~ A copy of the submittal may be viewed free of charge at the NRC Public Document Room, {

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2120 L Street, NW, (Lower Level), Washington, DC. Members of the public who are in the !

Washington, DC, area can access the submittal via modem on the Public' Document Room l.

i i Bulletin Board (NRC's Advanced Copy Document Library), NRC subsystem at FedWorld, l l l l_ 703-321-3339. Members of the public who are located outside of the Washington, DC, area can dial FedWorld, 1-800-303-9672, or use the FedWorld Intemet address:

( fedworld. gov (Telnet). The document will be available na the bulletin board for 30 days after the signature date of this notice. If assistance is needed in accessing the document, please

! contact the FedWorld help desk at 703-487-4608. Additional assistance in locating the !

l i documed is available from the NRC Public Document Room, nationally at 1-800-397-4209, or within the Washington, D.C. Area at 202-634-3273. ;

Comments and questions should be directed to the OMB reviewer by (insert date 30 days l

after publication in the Federal Reaisterk I

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Edward Michlovich Office of Information and Regulatory Affairs (3150-0181)

NEOB-10202 Office of Management and Budget ,

Washington, DC 20503 l Comments can also be submitted by telephone at (202) 395-3084.

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The NRC Clearance Officer is Brenda Jo. Shelton, (301) 415-7233.

fh Dated at Rockidle, Maryland, this k day of [in/ .1997.

I l For the Nuclear Regulatory Commission.

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/jf a a ,/ c '/, < ta i

Amold E. Levin, Acting Designated Senior Official for Information Resources Management !

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ML20140J567

Text

SUMMARY

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