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 Inform ation Collection (IC) activity associated with the ICR. If mor e than one Part II is required, create a separate 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 Po llutants Emissions: Group I Polymers and Resins

4. Frequency of reporting (only to be completed if there are reporting requirements, check all that apply): 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 selection may be made. If multiple categories apply, you must create additional ICs to account for the burden associated with each category. 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 National Emission Standards for Hazardous Air Pollutants Emissi ons: Group I Polymers and Resins Part 40 CFR 63 Section 480

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 

### 2Revised 9/1/2006 

### 3 7. Federal Enterprise Architecture Business Reference Model:

Line of Business (check one) : Subfunction (check one) : Environmental Management Environmental Monitoring and Forecasting
Environmental Remediation Pollution Prevention and Control

Health Illness Prevention Immunization Management Public Health Monitoring Health Care Services Consumer Health and Safety

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 l isted. For a full listing of the FEA Business Reference Model categories and definitions, see: http://www.whitehouse.gov/omb/egov/docum ents/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: 19 Small Entity Number: 0 Percentage of responses 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 one selection may be made. If multiple categories apply, you must create additional ICs to account for the burden associated with each category. Selecting multiple subcategor ies within “Private Sector” will not affect then number of ICs required.

10. Frequency: How often on average will each respondent respond to the Information Collection?

Number of Respondents 19 per Year

Hour Business hour Day Business Day

Week Month

Decade Quarter Half-year Calculated Annual Frequency: 5 (responses per respondent per year)

Calculated Annual Number of Responses: 101

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 30 3,052 $84 $8,447 Recordkeeping 207 20,910 $0.00 $0.00 Third Party Disclosure

Total 237 23,963 $85 $8,447

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

### 4 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 101

Annual Hour
Burden 23,963

Annual Cost
Burden 8,446