PAPF~Wn~K Ri;OUCTION ACT SUBM·--·-... 

PleiH read the Instructions before completing this form. For additional forms or assistance In comP.Ietlng this form, contact your •j•ncy'a P&IJ4trwork Clearance Officer. Send two copies of this fonn, the co"ectlon Instrument to be reviewed the autP.ortlng statement, an an~ addiUonal documentation to: Office of Information and Regulatory Affairs, Office of Management and Budge Docket Library, Room 10 02, 725 17th Street NW, WeehJngtc)n, DC 20503. 

1. Agency/Subagency originating request 2. OMB control number b. [ I None 

U.S. Environmental Protection Agency a. 2060 - 0693 

3. Type of information collection (check one) 4.141 of review requested (check one) a. Regular submission a. I I [.,I New Collection b. ~ Emergency- Approval requested by 

b.[ 1 Revision of a currently approved collection c. Delegated 

c. I 1 Extension of a currently approved collection 5. Small entities 

d. [ 1 Reinstatement, without change, of a previously approved Will this information collection have a significant economic impact on 

collection for which approval has expired a substantial number of small entiUes? [V) Yes 1 ) No 

e.[ 1 Reinstatement, with changeli of a previously approved collection for which approval as expired 6. Requested expiration date 

f. [ 1 ExlsUng collection In use without an OMB control number a. llf1 Three yeans from approval date b. [ 1 Other Spectry: I 

For b-f, note Item A2 of SupporUng Statement instnJctions 

7. Title New Source Perfonnance Standards (NSPS) for New Residential Hydronic Heaters and Forced-Air Furnaces ( 40 CFR 

Part 60, Subpart QQQQ) 

8. Agency form number(s) (if applicable) 

9. Keywords Air pollution control, Environmental protection, Reporting and recordkeeping 

10. Abstract 

This ICR covers information collection requirements included in the final amended NSPS for new residential hydronic heaters and 

forced-air furnaces (40 CFR Part 60, Subpart QQQQ). The infonnation collected will be used to determine compliance status of the 

affected facilities subject to the final rule. 

11. Affected public (Matfr primary with ·p-lll1tl 1111 othel5 lhat apply with "x"} 12. Obligation to respond (check one) 

a._ Individuals or houaahold& d. Fanns a. [ I Voluntary b. P Business or olher for-profile. X Federal Government b. f l Required to obtain or retain benefits c;. = Nol-for-proflllnsUtullons f. lr Slate, Local or Tribal Govemmenl c. ., Mandatory 

13. Annual recordkeeplng and reporUng burden 14. Annual reporting and recordkeeping cost burden (in thousands of 

a. Number of respondents 41 dollars) 

b. Total annual responses 199 a. Total annualized capital/startup costs 3.191 

1. Percentage of these responses b. Total annual costs (O&M) 0 

collected electronically 100 % c. Total annualized cost requested 3,191 c. Total annual hours requested 2.337 

d. Current OMB invenlOfY 0 d. Current OMB lnvenlOf}' 0 

e. Difference 2,337 e. Difference 3,191 

f. ExplanaUon of difference f. Elcplanation of difference 

1. Program change 2,337 1. Program change 3.191 

2. Adjustment 2. Adjustment 

15. Purpose of information collection (Marie primary with •p• and all 16. Frequency of recordkeeplng or reporting (check all that apply) 

others that apply with "Xj a. (II] Recordkeeplng b. I 1 Third party disclosure a. _Application for benefits e. _ Program plannilg or management c. (v] Reporting b. _Program evaluation r. Research 1. [Ill On occasion 2. [ 1 Weekly 3. I I Monthly c. General purpose statistics g"'"JI Regulatory or compliance 4. [ I Quarterly 5. [ 1 Semi-annually 6. [v) Annually d. X Audit 7. [""') Biennially 8. VI Other (describe) One-time certification 

17. Statistical methods 18. Agency Contact (person who can best answer questions regarding 

Does this lnfonnaUon collection employ statistical methods the content of this submission) 

[ ) Yes 1111 No 

Name; David Cole 

Phone: (219) 541-55~5 

OMB83·1 10195 
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 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 proper performance of agency functions; 

(b) It avoids unnecessary duplication; 

(c) It reduces burden on small entities; 

(d) It used 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 period for recordkeeplng requirements; 

(g) It Informs respondents ofthe Information called for under 5 CFR 1320.8(b)(3): 

(I) Why the Information is being collected; 

(II) Use of Information; 

(Ill) Burden estimate; 

(lv) Nature of response (voluntary, required for a benefit, 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 (see note in Item 19 of Instructions); 

(I) It uses effective and efficient statistical survey methodology; and 

O)lt makes appropriate use of information technology. 

If you are unable to certify compliance with any of the provisions, identify the Item below and explain the reason In 

Item 18 of the Supporting Statement. 

Date 

OMBBJ-1 10195