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 sy**  **stem and use of the Information Collection Request, Review and A pproval Sy**  **stem (ICRA**

**S) 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 y**  **ou will find the following documents: OEI’s ICRA S 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 y**  **our appropriate ICR desk officer.**
**1. A gency**  **/Subagency**

**originating request:** US EPA
**2. Title:** National Emission Standards for Hazardous Air Pollutant Emissions: Polyether Polyols Production **3. Ty pe 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

- 0415
**EPA ICR Number:**  1811.06

**5. Ty pe 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 ) **:** T hree years from approval date Six Months from approval date (maximum for emergency) Other, please specify: (mm/yy)

**7. A bstract**  (4000 characters maximum, attach additional sheets as necessary): **EPA is proposing revisions for the National Emission Standards**  **for Hazardous A ir Pollutants (NESHA**  **P) for Poly ether Poly**  **ols. Potential respondents subject to the new requirements of the NE SHA**  **P include an estimated 23 existing facilities that produ**  **ce poly ether poly**  **ols. The total annual responses attributable to this ICR consist of additional information pertaining to emissions discharges from pressure release devices, which is prohibited in the proposed**  **rule, and reports submitted to satisfy**  **affirm ative defense provisions. No burden estimates are provided for new sources because no new facilities**  **are expected to be affected sources during the next 3 y ears.** Revised 1/30/2007 

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**8. Citations for A uthorizing Statute(s):** 

a. Public Law Nam e of law: Citation:

- Sec
b. US Code Nam e of Law: Clean Air Act Citation: 42 USC: 7401

c. Executive Order Nam e/Subject of EO: Citation: EO
d. Statute at Large Nam e of Statute: Citation: Stat
**9. A ssociated Rulemaking Information**  (For Rule Related ICRs Only):
RIN: 2060

– AR02 SAN: 5566 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 w ill enter this information into ICRAS. For ICRs associated with Interim Finals that are not significant 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 t his 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 has been published. The second notice will be published following O EI review and approval of the ICR. OEI will enter this information into ICRAS.
**11. A nnual Cost to Federal Government:**  5970.00 **12. Does this ICR contain survey s, censuses, or employ**  **statistical methods?** Yes No (If Yes, please attach Supporting Statement, Part B) **13. Is a Privacy**

**Impact A**

**ssessment required by the E**  **- Government A**  **ct of 2002 for this ICR?** Yes No (A PIA is needed for a new, electronic col lection of information.)
**14. A gency**  **Contact:** Nam e: Nick Parsons Phone: 919

- 541

- 5372 E

- mail: parsons.nick@epa.govRevised 1/30/2007 

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**15. Change in Burden:**
**A. Program Change Due to a New**  **Statute** If change in burden is a **Program Change Due to a New Statute** , identify the Citations for the New Statutory Requirements:

a. Public Law Nam e of law: Citation:

- Sec
b. US Code Nam e of Law: Citation: USC:

c. Executive Order Nam e/Subject of EO: Citation: EO
d. Statute at Large Nam e of Statute: Citation: Stat
**B. Program Cha**  **nge Due to A gency**  **Discretion** If change in burden is a **DECREA SE**  because of a **Program Change** due to **Ag ency**  **Discretion** , please categorize the decrease (select one): Cutting Redundancy Using Information Technology Changing Regulations Changing Forms Miscellaneous Actions If change in burden is a **INCREA SE**  because of a **Program Change** due to **Ag ency**  **Discretion** , please categorize the increase (select one): Changing 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 achieved or why the increase in burden occurred. (If you need more space, provide a short summary here and elaborate in t he Supporting Statement.) This is a revised data collection due to amendments to the rule. There are addi tional recordkeeping and reporting requirements resulting from the proposed amendments, however, the overall estimated burden has decreased because there are fewer major source facilities than previously estimated.Revised 1/30/2007 

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### PAPER WO RK REDUCTION ACT SUBMISSION WO RKSHEET 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, al ong 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 minimize the burden on small businesses or oth er 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 value of the information to agencies and the pub lic. 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 information technology to reduce burden and wh ere possible avoid unnecessary system and technology costs.Revised 1/30/2007 

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### PAPER WO RK REDUCTION ACT SUBMISSION WO RKSHEET

Part IV: Certification Certification for Paperwork Reduction Act Submissions On behalf of this Federal 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 is to be made with reference to those regulat ory 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 uses plain, coherent, and unambiguous terminology that is understandable to respondents; (e) Its implementation will be consistent and compatible with current reporti ng 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) W hy the information is being collected’ (ii) Use of in formation; (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 o ffice 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 su rvey methodology; and (j) It makes appropriate use of information technology.

Signature of Program Official Peter Tsirigotis, Director Sector Policies and Programs Division Office of Air Quality P lanning and Standards Date

Signature of Senior Official or designee Oscar Morales, Director Collection Strategies Division Office of Environmental Information DateRevised 1/30/2007 

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5 CFR 1320.9 reads “As part of the agency submission to OMB of a proposed collec tion of information, the agency (through the head 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, including 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 ext ent practicable and appropriate the burden 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) establi shing 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 information , 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 consistent and compatible, to the maximum extent practicable, with the existing reporting a nd 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 and 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 survey 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, agency efficiency and responsiveness 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 information 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 performanc e 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 p ublic 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 author ity), or mandatory (citing authority); “(v) the nature and extent of confidentiality to be provided, if any (citing authority); and “(vi) 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.”