Office of Marine & Aviation Operations: Occupational Health, Safety, and Readiness Forms

Forms and Documents

Document Name	Status
Form NF 57-10-02 Tuberculosis Screening Document Form and Instruction	Unchanged
Form NF 57-10-01 NOAA Health Services Questionnaire (NHSQ) Form and Instruction	Modified
0648-0824 30-day 90 FR 7081 2025-0121.pdf Supplementary Document	2025-01-21
0648-0824 Supporting Statement Part A.docx Supporting Statement A	2025-01-14
0648-0824 60-day 89 FR 88975 2024-1112.pdf Supplementary Document	2025-01-14
SORN COMMERCE-NOAA-22.pdf Supplementary Document	2025-01-14
NOAA Manual 209-10 Occupational Safety & Health Mgmt System.pdf Supplementary Document	2025-01-14
NOAA Policy 1008 - Tuberculosis Policy.pdf Supplementary Document	2024-01-19
USCODE 33-chap18-sec941.pdf Supplementary Document	2024-01-17
OMAO 1006 - Immunizations, Communicable Disease Protection, and Chemoprophylaxis.docx Supplementary Document	2024-01-17

IC Document Collections

IC ID	Document Title	Status
264469	Tuberculosis Screening Document Form and Instruction	Unchanged
264468	NOAA Health Services Questionnaire (NHSQ) Form and Instruction	Modified

ICR Details

OMB Control No: 0648-0824	ICR Reference No: 202501-0648-001
Status: Received in OIRA	Previous ICR Reference No: 202401-0648-010
Agency/Subagency: DOC/NOAA	Agency Tracking No:
Title: Office of Marine & Aviation Operations: Occupational Health, Safety, and Readiness Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/21/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	06/30/2027
Responses	1,000	1,000
Time Burden (Hours)	167	167
Cost Burden (Dollars)	0	0

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Abstract: This is a request for revision and extension of an existing collection currently in use with OMB approval. The NOAA Health Services Questionnaire NF 57-10-01 is being revised to include supportive questions to document previous sailing dates and clarifying medical information within NF 57-10-01 to ensure OMAO has a complete medical history for all personnel aboard NOAA vessels. These changes are minimal and not expected to increase the burden for completing this form. The National Oceanic and Atmospheric Administration's (NOAA) Office of Marine and Aviation Operations (OMAO) manages and operates NOAA's fleet of 15 research and survey ships and nine specialized environmental data-collecting aircraft . Comprised of civilians and officers of the NOAA Commissioned Officer Corps , OMAO also manages the NOAA Diving Program , NOAA Small Boat Program , and NOAA Uncrewed Systems Operations Center . The research and survey ships operated, managed, and maintained by OMAO comprise the largest fleet of federal research ships in the nation. Ranging from large oceanographic research vessels capable of exploring the world’s deepest ocean, to smaller ships responsible for charting the shallow bays and inlets of the United States, the fleet supports a wide range of marine activities including fisheries surveys, nautical charting, and ocean and climate studies. This collection covers the forms that are required to make medical readiness recommendations.

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Authorizing Statute(s): US Code: 33 USC 941 Name of Law: Navigation and Navigable Waters
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 88975	11/12/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 7081	01/21/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
NOAA Health Services Questionnaire (NHSQ)	NF 57-10-01	NOAA Health Services Questionnaire
Tuberculosis Screening Document	NF 57-10-02	Annual Tuberculosis Screening Document

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,000	1,000	0	0	0	0
Annual Time Burden (Hours)	167	167	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $528,481

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

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 language 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) about:

(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.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/21/2025

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