Revised 1/30/2007 

### 1 PAPERWORK REDUCTION ACT SUBMISSION WORKSHEET

PART I: Information Collection Request

This worksheet replaces the previous OMB 83

- I form for Information Collection Requests (ICRs). This worksheet is intended to help ICR

preparers transition between the pa per 83

- I system and use of the Information Collection Request, Review and Approval System (ICRAS)

for submitting ICRs to OMB. This form is not intended for submission to OMB. For additional guidance on completing this wor ksheet

, please see EPA’s ICR webs ite at http://intranet.epa.gov/icrintra/ . There you will find the following docume nts: OEI’s ICRAS Instructions

(under Prepare ICR Package tab) and OMB ’s ROCIS IC Q&A (located under the Download Guidance tab) , as well as the contact information

for your app r opriate ICR desk officer.

1. Agency/Subagency originating request: OAR/OAQPS/RDPAG

2. Title: National Emission Standards for Hazardous Air Pollutants for P repared Feeds Manufacturing Area Source Category

3. Type of Information Collection ( check one ) :

New collection

Extension of a currently approved collection

Revision of a currently approved collection

Nonmaterial or non

- substantive change to a currently approved collection

(formerly called the 83

- C) 4. OMB Control Number (OCN) : 2060

- new

EPA ICR Number: 2354.0 2

5

. Type of review requested ( check one ) :

Regular

Emergency

– Approval Requested by: (mm/dd/yy)

Delegated

(If emergency, please submit justification as a separate attachment ) 6

. Requested expiration date ( check one ) :

Three years from approval date

Six Months from approval date (maximum for emergency)

Other, please sp ecify: (mm/yy)

7 . Abstract (4000 characters maximum, attach additional sheets as necessary): EPA is pro mulgating N ational E mission S tandards for

H azardous A ir P ollutants (NESHAP) for the P repared Feeds Manufacturing Area Source Category. The standards include management

practices and equipment standards for new and existing plants based on the generally available control technology (GACT) for the area

source category. Potential respondents subject to the area source NESHAP include an estimat ed 1,8 00 existing Prepared Feeds

Manufacturing facilities. The total annual responses attributable to this ICR consist of one

- time notifications for each existing facility. The

owner or operator would be required to submit the initial notification by the compliance date, based on requirements in the proposed rule.

No burden estimates are provided for new sources because no new facilities are expected to be affected sources during the nex t three

years.Revised 1/30/2007 

### 2

8 . Citations for Authorizing Statute(s) :

a. Public Law

Name of law: Clean Air Act

Citation: 42 USC 7401 et seq

- Sec 112

b. US Code

Name of Law:

Citation: USC:

c. Executive Order

Na me/Subject of EO:

Citation : EO

d. Statute at Large

Name of Statute:

Citation: Stat

9 . Associa ted Rulemaking Information (For Rule Related ICRs Only) :

RIN: 2060

– A098 SAN: 5201 Stage of Rulemaking (check one) :

Proposed Rule

Interim Final or Final Rule

For a Proposed Rule, OMB will not consider an ICR complete until the Notice of Proposed Rulemaking has been published. OEI will enter this

information into ICRAS.

For ICRs associated with Interim Final s that are not significan t under EO 12866, please attach a draft of the rule

.

10 . Federal Register Notices & Comments :

Federal Register Citation ( For Non

- Rule Related and Renewal ICRs Only) :

60

- day Notice: Volume: Page number: Publication Date:

( 30

- day Notice: Volume: Page number: Publication Date )

Did the Agency receive public comments on this ICR? Yes No

Unless submitted as an Emergency ICR or Associated with a Rulemaking, OMB will not consider an ICR complete until the 30

- day notice

h as been published. The second notice will be published following OEI review and approval of the ICR. OEI will enter this information in to ICRAS

.

11 . Annual Cost to Federal Government: 87143.00

12. Does this ICR contain surveys, censuses, or employ statistical methods? Ye s No

( If Yes, please attach Supporting Statement, Part B )

13. Is a Privacy Impact Assessment required by the E

- Government Act of 2002 for this ICR? Yes No

(A PIA is needed for a new, electronic collection of informatio n.)

14. Agency Contact:

Name: Jan King

Phone: (919) 541

- 5665

E

- mail: king.jan @epamail.epa.govRevised 1/30/2007 

### 3

15 . Change in Burden:

A. Program Change Due to a New Statute

If change in burden is a P rogram C hange D ue to a N ew S tatute , identify the C itation s for the N ew S tatutory R equirements:

a. Public Law

Name of law:

Citation:

- Sec

b. US Code

Name of Law:

Citation: USC:

c. Executive Order

Name/Su bject of EO:

Citation : EO

d. Statute at Large

Name of Statute:

Citation: Stat

B. Program Change Due to Agency D iscretion

If change in burden is a DECREASE because of a P rogram C hange due to A gency D iscretion , please categorize the decrease (select one):

Cutting Redundancy

Using Information Technology

Changi ng Regulations

Changing Forms

Miscellaneous Actions

If change in burden is a INCREASE because of a P rogram C hange due to A gency D iscretion , please categorize the increase (select one):

Chan ging Regulations

Miscellaneous Actions

C

. Explanation of Change in Burden

Explain the reasons for any program changes or adjustments reported; that is, provide a short statement addressing how the re duction in burden

was achi eved or why the increase in burden occurred. (If you need more space, provide a short summary here and elaborate in the Suppo rting

Statement.)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: National Emission Standards for Hazardous Air Pollutants: Prepared Fee ds Manufacturing

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

Required 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 eac h

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 app licable):

Title Part Section 11619

Title Part Section

Title Part Section

Title Part Section

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 

### 2

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: 1,800

Small Entity Number: 1,692

Percentage of respon ses collected electronically: 0 Affected Public (check one) :

Individuals or Households

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

Business or other for

- profit

Not

- for

- profit institutions

Farms

State, Local, or Tribal Governments

Federal Government

Note: Only o ne selection may be made. If multipl e 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 eac h respondent respond

to the Information Collection?

Calculated Annual Frequency: 1

(responses per respondent per year)

Calculated Annual Number of Responses: 1, 2 00 Number of Respondents 1,800 per Year

Hour Business hour

Day Business Day

Week Month

Decade Quarter

Half

- year

11. Hour and Cost Burden: Enter the 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 0. 86 1, 035

Recordkeeping 17.3 20,792 $ 22 $ 26,451

Third Party Disclosure

Total 18.2 21827 $ 22 $ 26,451

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

### 3

12. Annual Responses and Burden Change

Total Requested Program Change

due to Ne w

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 1, 2 00

Annual Hour

Burden 2 1,827

Annual Cost

Burden $ 26,451Revised 1/30/2007 

### 4 

### PAPERWORK REDUCTION ACT SUBMISSION WORKSHEET

Part III: Information Collection Request Completeness Check

Complete this checklist prior to submitting the information collection package to the Clearance Officer. The Clearance Offic er

will use the information contained in this checklist, along with other information, to certify the information collection prior to

submission to OMB.

The supporting statement (check all that apply):

a. Identifies the statute or regulation authorizing the collection of the information

b. Describes efforts taken to avoid the collection of similar information already available, or collected

under a different information collection

c. Describes, if applicable, methods to mi nimize the burden on small businesses or other small entities

d. Is written using plain English, and all terminology used is unambiguous and understandable to those

required to respond to the collection

e. Indicates how long records specified in the collection are to be maintained by persons required to

maintain the records

f. Has dedicated resources to ensure the proper use and processing of the information being collected to

enhance (as appropriate) the valu e of the information to agencies and the public.

g. Indicates the use of a statistical survey method (if applicable) that produces valid and reliable results

while minimizing undue burden.

h. Describes the intended use of in formation technology to reduce burden and where possible avoid

unnecessary system and technology costs.Revised 1/30/2007 

### 5 

### PAPERWORK REDUCTION ACT SUBMISSION WORKSHEET

Part IV: Certification

Certification for Paperwork Reduction Act Submissions

On behalf of this Feder al agency, 1 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 i s to be made with reference to those regulatory provisions as set forth 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 prope r 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 co nsistent 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 infor mation 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 con trol 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 (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.

Signature of Program Official Date

Signature of Senior Official or designee

Oscar Morales, Director

Collection Strategies Division

Office of Environmental Information DateRevised 1/30/2007 

### 6

5 CFR 1320.9 reads “As part of the agency submission to OMB of a proposed collection of information, the agency (through the hea d of

the agency, the Senior Official or their designee) shall certify (and provide a record supporting such certification) that th e proposed

collection of information

--

“(a) is necessary for the proper performance of the functions of the agency, inc luding that the information to be collected will have

practical utility;

“(b) is not unnecessarily duplicative of information otherwise reasonably accessible to the agency;

“(c) reduces to the extent practicable and appropriate the burd en on persons who shall provide information to or for the agency,

including with respect to small entities, as defined in the Regulatory Flexibility Act 5 U.S.C § 601(6)), the use of such tec hniques as:

“(1) establishing differing compliance or reporting requirements or timetables that take into account the resources available

to those who are to respond;

“(2) the clarification, consolidation, or simplification of compliance and reporting requirements; or collection of informati on ,

or any part thereof;

“( 3) an exemption from coverage of the collection of information, or any part thereof;

“(d) is written using plain, coherent, and unambiguous terminology and is understandable to those who are to respond;

“(e) is to be implemented in ways consi stent and compatible, to the maximum extent practicable, with the existing reporting and

recordkeeping practices of those who are to respond;

“(f) indicates for each recordkeeping requirement the length of time persons are required to maintain the records specified;

“(g) informs potential respondents of the information called for under § 1320.8(b)(3); [see below]

“(h) has been developed by an office that has planned and allocated resources for the efficient and effective management a nd use of

the information to be collected, including the processing of the information in a manner which shall enhance, where appropr iate, the

utility of the information to agencies and the public;

“(I) uses effective and efficient statistical s urvey methodology appropriate to the purpose for which the information is to be collected;

and

“(j) to the maximum extent practicable, uses appropriate information technology to reduce burden and improve data quality, ag ency

efficiency and responsi veness to the public.”

NOTE: 5 CFR 1320.8(b)(3) requires that each collection of information:

“(3) informs and provides reasonable notice to the potential persons to whom the collection of information is addressed of:

“(I) the reasons the informa tion is planned to be and/or has been used to further the proper performance of the functions of

the agency;

“(ii) the way such information is planned to be and/or has been used to further the proper performance of the functions of

the agency;

“(iii) an estimate, to the extent practicable, of the average burden of the collection (together with a request that the public

direct to the agency any comments concerning the accuracy of this burden estimate and any suggestions for reducing this

burden);

“(iv) whether responses to the collection of information are voluntary, required to obtain or retain a benefit (citing authority),

or mandatory (citing authority);

“(v) the nature and extent of confidentiality to be provided, if any (citing authority); and

“(v i) the fact that any agency may not conduct or sponsor, and a person is not required to respond to, a collection of

information unless it displays a currently valid OMB control number.”