ML20217K199

Notice of OMB Review of Information Collection Entitled NRC Form 396,Certification of Medical Exam by Facility Licensee & Solicitation of Public Comment

ML20217K199
Person / Time
Issue date:	10/20/1999
From:	Shelton B NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
To:
Shared Package
ML20217K203	List: ML20217K199 ML20217K214
References
NUDOCS 9910260071
Download: ML20217K199 (7)

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[7590-01-P]

U. S. NUCLEAR REGULATORY COMMISSION f

Agency Information Collection Activities: - Submission for OMB Review; Comment Request AGENCY: U. S. Nuclear Regulatory Commission (NRC)

ACTION: Notice of the OMB review ofinformation collection and solicitation of public comment.'

SUMMARY

The NRC has recently submitted to OMB for review the following proposal for the collection of information under 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 control number.

1. Type of submission, new, revision, or extension: Extension 1

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2. The title of the information collection: NRC Form 396, Certification of Medical Examination by Facility Licensee

3. The form number if applicable: NRC Form 396 9910260071 991020 l PDR ORC EUSOMB ' -

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4. How often the collection is required: Upon application for an initial operator license, every six years for the renewal of operator or senior operator license, and upon notices of disability.

5. Who will be required or asked to report: Facility employers of applipants for operator licenses.

6. An estimate of the number of responses: 1116

7. The estimated number of annual respondents: 141

8. An estimate of the total number of hours needed annually to complete the requirement or request: 730 (244 for reporting [.25 hours2.893519e-4 days <br />0.00694 hours <br />4.133598e-5 weeks <br />9.5125e-6 months <br /> per response) and 486 hours0.00563 days <br />0.135 hours <br />8.035714e-4 weeks <br />1.84923e-4 months <br /> for recordkeeping [3.4 hours4.62963e-5 days <br />0.00111 hours <br />6.613757e-6 weeks <br />1.522e-6 months <br /> per recordkeeper]).

9. An indication of whether Section 3507(d), Pub. L.104-13 applies: Not  :

1 applicable

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10. Abstract: NRC Form 396 is used to transmit information to the NRC i f

regarding the medical condition of applicants for initial or renewal operator licenses 'nd for the maintenance of medical records for all licensed operators. The information is used to determine l

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. . whether the physical condition and general health of applicants for.

operator licenses is such th t the applicant would not be expected to 7

L. cause operational errors endangering public health and safety.

- A copy of the final supporting statement may be viewed free of charge at the NRC Public

. Document Room,2120 L Street, NW (lower level), Washington, DC. OMB clearance requests are available at the NRC worldwide web site (http://www.nrc. gov /NRC/PUBLIC/OMB/index.html).

.. The document will be available on the' NRC home pcge site for 60 days after the signature date

~of this notice, f

Comments and questions should be directed to the OMB reviewer listed below by (insert date 30 i 4

days after publication in the Federal Reaister). Comments received after this date will be l considered if it is practical to do so, but assurance of consideratinis cannot be given to comments received after this date.

Erik Godwin .

Office of Information and Regulatory Affairs (3150-0024)

NEOB-10202 -

. Office of Management and Budget -

Washington, DC 20503 {

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Comments can also be submitted by telephone at (202) 395-3087. .

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

Dated at Rockvi0e, Maryland, this ;,#r ' day of f/vr 1999.

For th'e Nuclear Regulatory Commission.

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• BFenda'Jo. Sheltori?NR(Clearance Officer Offk:e of'the Chief Information Officer

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- Comments can also be submitted by telephone at (202) 395-3087.

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

I Dated at Rockville, Maryland, this day of 1999.

For the Nuclear Regulatory Commission. )

l Brenda Jo. Shelton, NRC Clearance Officer Office of the Chief Information Officer

• SEE PREVIOUS CONCURRENCE 1 I

' DOCUMENT NAME: PSOMB 3150-0024 - 396 FORM.wpd {

To receive a copy of this document, indicate in the box: *C' = Copy without attachment /enctosure 'E' = Copy with attachment / enclosure j

'N' = No copy j I

OFFICE SC:10HBA:10HB:DIPM:NRR E C:10HB:DIPM:NRR l N D:DIPM:NRR N NAME *DTrimble *RGallo *BBoger

DATE 09/07/99 09/07/99 09/08/99 _

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0FFICE PMAS:NRR. E OCIO E i

NAME *DMcCain BSheltdib DATE 09/16/99 10/ R /99

-OFFICIAL RECORD COPY l

4 Comments can also be submitted by telephone at (202) 395-3087.

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

3 Dated at Rockville, Maryland,'this day of 1999.

For the Nuclear Regulatory Commission.

Brenda Jo. Shelton, NRC Clearance Officer Office of the Chief Information Officer

• SEE PREVIOUS CONCURRENCE

- DOCUMENT NAME: P:\OMB 3150-0024 - 396 FORM.wpd

' Te receive a copy of this document, Indicate in the box: "C' = Copy without attachment / enclosure "E" = Copy with attachment / enclosure "N" = No copy 0FFICE~ SC:10HBA:10HB:DIPM:NRRIE C:10HB:0IPM:NRRIN D:DIPM:NRR l N NAME *DTrimble *RGallo *RBoger DATE~ 09/07/99 09/07/99 09/08/99 0FFICE PMAS:NRR _ F OCIO E NAME DMcCain 6 7 7) BShelton DATE 09/IL' /99 09/ /99 OFFICIAL RECORD COPY -

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' Cor.iments can also be submitted by telephor!e at (202) 395-3087.

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

Dated at Rockville, Maryland, this day of 1999.

For the Nuclear Regulatory Commission.

4 Brenda Jo.'Shelton, NRC Clearance Officer Office of the Chief information Officer DOCUMENT NAME: P;\OMB 3150-0024 - 396 FORM.wpd

. To receive a copy of this document. Indicate in the box: "C" = Copy without nt/ enclosure *E' = Copy with attachment / enclosure

.:t-0FFICE SC:10HBA:10HB:DIPM:NRR- E C:10f@M: NRRIN D:DIPM:NRR l N NAMF DTrimble >>7 */W'* RGalll a BBocer Y DATE 09/ 7 /99 09/ '//99 09/ 8 /99 0FFICE PMAS:NRR E OCIO E NAME DMcCain M BShelton DATE 09/ Q /99 09/ /99 OFFICIAL RECORD COPY l

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