Revised 9/1/2006 

### 1 PAPERWORK REDUCTION ACT SUBMISSION WORKSHEET

Part II: Information Collection Detail

IMPORTANT: A separate Part II must be completed for each Information Collection (IC) activity associated with the ICR. If more than one Part II is

required, create a sep arate Part II document for each IC. For more information see OEI’s ICR website at http://intranet.epa.gov/icrintra/ . There you will

find information on completing this form (see OEI’s ICRAS instructions under the Prepare an ICR tab) and information on how break your ICR into ICs ( see

OMB’s ROCIS IC Q&A under the Download Guidance tab).

1. Title of Information Collection: NESHAP for Oil and Natural Gas Production

2. Is this a common form?

Yes

No

( Select Yes to identify forms that EPA is

willing to host for potential use by other

Federal Agencies.

) 3. Obligation to respond (check one):

Voluntary

Require d to obtain or retain benefits

Mandatory

Note: Only one select

ion may be made. If multiple

cat egories apply, you must create additional ICs to

account for the burden associated with each

category. 4. Frequency of reporting (only to be completed if

there are reporting requirements, check all that apply):

Hourly

Daily

Weekly

Monthly

Yearly Every Decade

Quarterly

Semi

- Annually

Biennially

Once

Occasionally

5. CFR Citation(s) for the information collection under review (if applicable):

Title 40 Part 63 Section 760

Title Part Section

Title Part Section

Title Part SectionRevised 9/1/2006 

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6. Information Collection Instruments/Forms (if applicable) :

Form Name:

Form Number:

URL (required if electronic) :

Is this form available electronically? Yes No If yes, can this form be submitted electronically? Yes No

Form Name:

Form Number:

URL (required if electronic) :

Is this form available electronically? Yes No If yes, can this form be submitted electronically? Yes No

Form Name:

Form Number:

URL (required if electronic) :

Is this form available electronically? Yes No If yes, can this form be submitted electronically? Yes No

Attach additional sheets if necessary.

Note: Instruments/Forms must be submitted/uploaded as a separate attachment.Revised 9/1/2006 

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7. Federal Enterprise Architecture Business Reference Model:

Line of Business (check one) : Subfunction (check one) :

Environmental Management Environmental Monitoring and Forecasting

Environmental Remediation

Pollution Pre vention and Control

Health Illness Prevention

Immunization Management

Public Health Monitoring

Health Care Services

Consumer Health and Safet y

Natural Resources Water Resource Management

Conservation, Marine and Land Management

Recreational Resource Management and Tourism

Agricultural Innovation and Services

Note: Most EPA ICRs will be aligned with the Environmental Management FEA Line of Business. Other likely categories are also listed. For a full listing of

the FEA Business Reference Model categories and definitions, see:

http://www.whitehouse.gov/omb/egov/documents/FY07_Ref_Model_Mapping_QuickGuide.pdf

.

8. Privacy Act System of Records (if applicable) :

Title:

Federal Register Citation: Volume Page Number Publication Date

9. Respondents

Total Number: 3,991

Small Entity Number:

Percentage of respon ses collected electronically: 100 Affected Public (check one) :

Individuals or Households

Private Sector (if private sector, check all that apply)

Business or other f or

- profit

Not

- for

- profit institutions

Farms

State, Local, or Tribal Governments

Federal Government

Note: Only o ne selection may be made. If multi ple categories apply, you

must create additional ICs to account for the burden associated with each

category. Selecting multiple subcategories within “Private Sector” will not

affect then number of ICs required.

10. Frequency: How often on average will e ach respondent respond to the

Information Collection?Revised 9/1/2006 

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Number of Respond ents 846 per Year

Ho ur Business

hour

Day Business

Day

Week Month

Decade Quarter

Half

year Calculated Annual Frequency: 2.87

(responses per respondent per year)

Calculated Annual Number of Responses: 2,426

11. Hour and Cost Burden: Enter t he hours and cost (per response) broken out by reporting, record keeping, and third party disclosure:

Hours per Response Total Annual Hour Burden Cost per Response Total Annual Cost Burden

Reporting 11.6 9, 806 $ 3 88.01 $ 328 ,251

Recordkeeping 13.4 53,49 8 $ 448.72 $ 1,790,797

Third Party Disclosure

Total 25 6 3,304 $ 836.73 $ 2, 119,048

IMPORTANT : “Cost per Response” and “Total Annual Cost Burden” should include Capital/Startup and O&M costs only.Revised 9/1/2006 

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12. Annual Responses and Burden Change

Total Requested Program Change

due to New

Statute Program Change

due to Agency

Discretion Change due to

Adjustment in

Agency Estimate Change due to

Violation of the

PRA Currently

Approved

Annual

Responses 2,426 27 2,399

Annual Hour

Burden 6 3,304

- 11 5

, 670 178,974

Annual Cost

Burden $ 2, 119

, 048

- $1 4

, 530

, 655 $ 16,649,703