Information Collection; Health Screening Questionnaire, 72443-72444 [E8-28343]
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mstockstill on PROD1PC66 with NOTICES
Federal Register / Vol. 73, No. 230 / Friday, November 28, 2008 / Notices
• Purpose of application: Credit on
next year’s fees, refund of fees, or
transfer of credit to another account.
• Information on the allotment;
number of cattle, horses, or sheep;
• Period range not used.
• Reason for less use than permitted.
• Signature of Permittee.
Information collected on this form
enables the Forest Service to evaluate a
grazing permittee’s request for refund,
credit, or transfer of the unused potion
of the preceding season’s grazing fees
paid to the Forest Service for the
occupancy of the National Forest
System lands by permitted livestock.
FS–2200–2; Application for
Temporary Grazing or Livestock Use
Permit collects the following
information:
• Name and address of applicant.
• Type, amount, and location of
requested grazing.
• Period of use.
• Grazing allotment.
Information collected on this form
enables the Forest Service to determine
whether individuals qualify for a
temporary grazing or livestock use
permit, which authorizes grazing on
certain NFS lands for a period not to
exceed one year. The Forest Service
uses the information on this form to
determine whether the applicant is
likely to comply with grazing permit
terms and conditions.
FS–2200–12; Waiver of Term Grazing
Permit enables the Forest Service to
terminate an individual’s grazing
privileges on certain NFS lands based
upon that individual’s sale or transfer of
base property, permitted livestock, or
both to another individual who desires
to acquire a new grazing permit. The
waiver enables the Forest Service to
cancel the grazing permit held by the
individual who sold or transferred the
base property, permitted livestock, or
both; and to identify the individual who
acquired the base property, permitted
livestock, or both as the preferred
applicant for a new grazing permit.
FS–2200–13; Escrow Waiver of Term
Grazing Permit Privileges collects
information on loans made to
permittees. The Forest Service uses the
information to record the name and
address of a permittee’s lender, the
amount of the loan, and the due date for
repayment. The information assists
Agency officials in determining whether
to hold in escrow, on behalf of the
lender, all of the privileges associated
with the grazing permit except the
privilege to graze. The Forest Service
uses the collected information to (1)
notify the lender of important issues
associated with the administration of
the grazing permit and (2) facilitate the
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17:16 Nov 26, 2008
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transfer of a grazing permit to a lender
if the permittee defaults on a loan.
FS–2200–16; Application for Term
Grazing Permit collects the following
information:
• Name and address of applicant.
• Type, amount, and location of
requested grazing.
• Period of use.
• Grazing allotment.
The information collected on this
form enables the Forest Service to
evaluate an applicant’s eligibility and
qualification to hold a term grazing
permit authorizing the use of National
Forest System lands for livestock
grazing purposes, to determine the
applicant’s ability to comply with
grazing permit terms and conditions,
and to notify the applicant in writing of
matters associated with the
administration of permitted grazing
including, but not limited to, bills for
the fees associated with the permitted
grazing.
FS–2200–17; Application for Term
Private Land Grazing Permit collects the
following:
• Name and address of applicant.
• Type, amount, and location of
requested grazing.
• Period of use.
• Grazing allotment.
The information collected on this
form enables the Forest Service to
evaluate an applicant’s eligibility and
qualification to hold a term private
land-grazing permit, which authorizes
the use of National Forest System lands
and private lands controlled by the
applicant for livestock grazing purposes.
The information also enables the Forest
Service to determine the applicant’s
ability to comply with grazing permit
terms and conditions, and to notify the
applicant in writing of matters
associated with the administration of
permitted grazing.
FS–2200–25; Ownership Statement by
Corporation or Partnership collects the
following:
• Name of corporation or partnership.
• The title, signing authority, mailing
address, shares owned or ownership of
each stockholder or partner.
The information on this form enables
the Forest Service to evaluate whether a
corporation or partnership is eligible
and qualified to hold a term grazing
permit authorizing grazing on certain
National Forest System lands, whether
the corporation is authorized to conduct
business in the state in which the
National Forest System lands to be
grazed are located, and which
shareholders or partners are authorized
to sign official documents on behalf of
the corporation or partnership.
Estimate of Annual Burden: 25
minutes.
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72443
Type of Respondents: Individuals,
businesses, and farms.
Estimated Annual Number of
Respondents: 3900.
Estimated Annual Number of
Responses per Respondent: 1.
Estimated Total Annual Burden on
Respondents: 1950 hours.
Comment Is Invited
Comment is invited on: (1) Whether
this collection of information is
necessary for the stated purposes and
the proper performance of the functions
of the agency, including whether the
information will have practical or
scientific utility; (2) the accuracy of the
agency’s estimate of the burden of the
collection of information, including the
validity of the methodology and
assumptions used; (3) ways to enhance
the quality, utility, and clarity of the
information to be collected; and (4)
ways to minimize the burden of the
collection of information on
respondents, including the use of
automated, electronic, mechanical, or
other technological collection
techniques or other forms of information
technology.
All comments received in response to
this notice, including names and
addresses when provided, will be a
matter of public record. Comments will
be summarized and included in the
submission request toward Office of
Management and Budget approval.
Dated: November 19, 2008.
Charles L. Myers,
Associate Deputy Chief, National Forest
System.
[FR Doc. E8–28346 Filed 11–26–08; 8:45 am]
BILLING CODE 3410–11–P
DEPARTMENT OF AGRICULTURE
Forest Service
Information Collection; Health
Screening Questionnaire
Forest Service, USDA.
Notice; request for comment.
AGENCY:
ACTION:
SUMMARY: In accordance with the
Paperwork Reduction Act of 1995, the
Forest Service is seeking comments
from all interested individuals and
organizations on the extension (with
revision) of a currently approved
information collection, Health
Screening Questionnaire.
DATES: Comments must be received in
writing on or before January 27, 2009 to
be assured of consideration. Comments
received after that date will be
considered to the extent practicable.
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72444
Federal Register / Vol. 73, No. 230 / Friday, November 28, 2008 / Notices
Comments concerning this
notice should be addressed to WO–
FAM, National Interagency Fire Center,
3833 S. Development Ave., Boise, ID
83705, Attention: Larry Sutton.
Comments also may be submitted via
facsimile to 208–387–5735 or by e-mail
to: lsutton@fs.fed.us.
The public may inspect comments
received at the National Safety Office,
National Interagency Fire Center, Forest
Service, USDA, 3833 Development
Avenue, Boise, ID, from 8 a.m. to 4:30
p.m. Monday through Friday (Mountain
Standard Time). Visitors are encouraged
to call ahead to 208–387–5607 to
facilitate entry to the building.
FOR FURTHER INFORMATION CONTACT:
Larry Sutton, Forest Service Fire
Operations Risk Management Specialist,
208–387–5970. Individuals who use
telecommunication devices for the deaf
(TDD) may call the Federal Relay
Service (FRS) at 1–800–877–8339
twenty-four hours a day, every day of
the year, including holidays.
SUPPLEMENTARY INFORMATION:
Title: Health Screening Questionnaire.
OMB Number: 0596–0164.
Expiration Date of Approval: August
31, 2009.
Type of Request: Extension with
revision.
Abstract: The Protection Act of 1922
(16 U.S.C. 594) authorizes the Forest
Service to fight fires on National Forest
System lands. This information
collection is an approved Forest Service
collection. The collection covers the
USDA Forest Service (FS) and the
Department of the Interior (DOI), and
contains the information collection
activities and burden hours for both
agencies.
Wildland firefighters perform long
hours of arduous labor in adverse
conditions requiring. It is imperative
that these firefighters be in sufficient
physical condition to avoid injury to
themselves or their coworkers. Federal
employees and private individuals
seeking employment as a firefighter
with the FS or DOI must complete the
Health Screening Questionnaire (HSQ).
This information collection covers the
forms and burden hours associated with
the private individuals who apply for
firefighter positions with the
aforementioned agencies.
Prospective firefighters must complete
form FS–5100–31, Health Screening
Questionnaire, when seeking
employment as a new firefighter with
the Forest Service or Department of the
Interior. This form collects the following
information:
• Name
• Medical history
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ADDRESSES:
VerDate Aug<31>2005
17:16 Nov 26, 2008
Jkt 217001
• Current medical symptoms
• Other health issues
• Cardiovascular risk factors
The information collected pertains to
an individual’s health status and health
history in an effort to determine if any
physical conditions exist that might
result in injury or death during fitness
testing or when fighting a wildfire. If
Federal agency officials determine,
based on the collected information, that
an individual may not be physically
able to train for or take a Work Capacity
Test, the agency will require the
individual to undergo a physical
examination by a physician.
Form FS–5100–30, Work Capacity
Test: Informed Consent, is signed by
those deemed to be in sufficient health
to undergo a Work Capacity Test. The
Work Capacity Test determines the level
of an individual’s aerobic fitness, level
of muscular strength, and muscle
endurance. The consent form is
necessary to ensure the individual
taking the test is aware of the various
testing levels (arduous, moderate, and
light) and the risks involved. The
individual indicates the following:
• They have read the information on
the form, the brochure ‘‘Work Capacity
Test’’ and understand the purpose,
instructions, and risks of the test.
• They have read the information,
understood, and truthfully answered the
HSQ.
• Test to be taken—pack test
(arduous), field test (moderate), or walk
test (light).
Failure to collect this data could
result in injuries or deaths during the
‘‘Work Capacity Test’’ and while
working on wildland fires. The
information provided by an applicant
for Federal employment is stored in
secured official files, maintained
according to Agency regulations. The
information gathered is not available
from other sources.
Estimate of Annual Burden: 5
Minutes.
Type of Respondents: Individuals
seeking employment as firefighters.
Estimated Annual Number of
Respondents: 10,552.
Estimated Annual Number of
Responses per Respondents: 1.
Estimated Total Annual Burden on
Respondents: 876.
Comment Is Invited
Comment is invited on: (1) Whether
this collection of information is
necessary for the stated purposes and
the proper performance of the functions
of the agency, including whether the
information will have practical or
scientific utility; (2) the accuracy of the
agency’s estimate of the burden of the
PO 00000
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Fmt 4703
Sfmt 4703
collection of information, including the
validity of the methodology and
assumptions used; (3) ways to enhance
the quality, utility, and clarity of the
information to be collected; and (4)
ways to minimize the burden of the
collection of information on
respondents, including the use of
automated, electronic, mechanical, or
other technological collection
techniques or other forms of information
technology.
All comments received in response to
this notice, including names and
addresses when provided, will be a
matter of public record. Comments will
be summarized and included in the
submission request toward Office of
Management and Budget approval.
Dated: November 21, 2008.
Robin L. Thompson,
Associate Deputy Chief, State and Private
Forestry.
[FR Doc. E8–28343 Filed 11–26–08; 8:45 am]
BILLING CODE 3410–11–P
DEPARTMENT OF AGRICULTURE
Rural Housing Service
USDA Section 538 Guaranteed Rural
Rental Housing Program 2009 Industry
Forums—Open Teleconference and/or
Web Conference Meetings
Rural Housing Service, USDA.
Notice.
AGENCY:
ACTION:
SUMMARY: This notice announces a
series of teleconference and/or Web
conference meetings regarding the
USDA Section 538 Guaranteed Rural
Rental Housing Program, which will
take place during the months of January,
April, July and October in 2009. This
notice also outlines suggested
discussion topics for the meetings and
is intended to notify the general public
of their opportunity to participate in the
teleconference and/or Web conference
meetings.
The dates and times for the
teleconference and/or Web conference
meetings will be announced via e-mail
to parties registered as described below
in FOR FURTHER INFORMATION CONTACT.
FOR FURTHER INFORMATION CONTACT: Any
member of the public wishing to register
for the calls and obtain the call-in
number, access code, Web link and
other information for any of the public
teleconferences and or Web conferences
may contact James F. Carey, Financial
and Loan Analyst, Multifamily Housing
Guaranteed Loan Division, Rural
Development, United States Department
of Agriculture, telephone: (202) 401–
DATES:
E:\FR\FM\28NON1.SGM
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]]>Agencies
[Federal Register Volume 73, Number 230 (Friday, November 28, 2008)]
[Notices]
[Pages 72443-72444]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-28343]
-----------------------------------------------------------------------
DEPARTMENT OF AGRICULTURE
Forest Service
Information Collection; Health Screening Questionnaire
AGENCY: Forest Service, USDA.
ACTION: Notice; request for comment.
-----------------------------------------------------------------------
SUMMARY: In accordance with the Paperwork Reduction Act of 1995, the
Forest Service is seeking comments from all interested individuals and
organizations on the extension (with revision) of a currently approved
information collection, Health Screening Questionnaire.
DATES: Comments must be received in writing on or before January 27,
2009 to be assured of consideration. Comments received after that date
will be considered to the extent practicable.
[[Page 72444]]
ADDRESSES: Comments concerning this notice should be addressed to WO-
FAM, National Interagency Fire Center, 3833 S. Development Ave., Boise,
ID 83705, Attention: Larry Sutton.
Comments also may be submitted via facsimile to 208-387-5735 or by
e-mail to: lsutton@fs.fed.us.
The public may inspect comments received at the National Safety
Office, National Interagency Fire Center, Forest Service, USDA, 3833
Development Avenue, Boise, ID, from 8 a.m. to 4:30 p.m. Monday through
Friday (Mountain Standard Time). Visitors are encouraged to call ahead
to 208-387-5607 to facilitate entry to the building.
FOR FURTHER INFORMATION CONTACT: Larry Sutton, Forest Service Fire
Operations Risk Management Specialist, 208-387-5970. Individuals who
use telecommunication devices for the deaf (TDD) may call the Federal
Relay Service (FRS) at 1-800-877-8339 twenty-four hours a day, every
day of the year, including holidays.
SUPPLEMENTARY INFORMATION:
Title: Health Screening Questionnaire.
OMB Number: 0596-0164.
Expiration Date of Approval: August 31, 2009.
Type of Request: Extension with revision.
Abstract: The Protection Act of 1922 (16 U.S.C. 594) authorizes the
Forest Service to fight fires on National Forest System lands. This
information collection is an approved Forest Service collection. The
collection covers the USDA Forest Service (FS) and the Department of
the Interior (DOI), and contains the information collection activities
and burden hours for both agencies.
Wildland firefighters perform long hours of arduous labor in
adverse conditions requiring. It is imperative that these firefighters
be in sufficient physical condition to avoid injury to themselves or
their coworkers. Federal employees and private individuals seeking
employment as a firefighter with the FS or DOI must complete the Health
Screening Questionnaire (HSQ). This information collection covers the
forms and burden hours associated with the private individuals who
apply for firefighter positions with the aforementioned agencies.
Prospective firefighters must complete form FS-5100-31, Health
Screening Questionnaire, when seeking employment as a new firefighter
with the Forest Service or Department of the Interior. This form
collects the following information:
Name
Medical history
Current medical symptoms
Other health issues
Cardiovascular risk factors
The information collected pertains to an individual's health status
and health history in an effort to determine if any physical conditions
exist that might result in injury or death during fitness testing or
when fighting a wildfire. If Federal agency officials determine, based
on the collected information, that an individual may not be physically
able to train for or take a Work Capacity Test, the agency will require
the individual to undergo a physical examination by a physician.
Form FS-5100-30, Work Capacity Test: Informed Consent, is signed by
those deemed to be in sufficient health to undergo a Work Capacity
Test. The Work Capacity Test determines the level of an individual's
aerobic fitness, level of muscular strength, and muscle endurance. The
consent form is necessary to ensure the individual taking the test is
aware of the various testing levels (arduous, moderate, and light) and
the risks involved. The individual indicates the following:
They have read the information on the form, the brochure
``Work Capacity Test'' and understand the purpose, instructions, and
risks of the test.
They have read the information, understood, and truthfully
answered the HSQ.
Test to be taken--pack test (arduous), field test
(moderate), or walk test (light).
Failure to collect this data could result in injuries or deaths
during the ``Work Capacity Test'' and while working on wildland fires.
The information provided by an applicant for Federal employment is
stored in secured official files, maintained according to Agency
regulations. The information gathered is not available from other
sources.
Estimate of Annual Burden: 5 Minutes.
Type of Respondents: Individuals seeking employment as
firefighters.
Estimated Annual Number of Respondents: 10,552.
Estimated Annual Number of Responses per Respondents: 1.
Estimated Total Annual Burden on Respondents: 876.
Comment Is Invited
Comment is invited on: (1) Whether this collection of information
is necessary for the stated purposes and the proper performance of the
functions of the agency, including whether the information will have
practical or scientific utility; (2) the accuracy of the agency's
estimate of the burden of the collection of information, including the
validity of the methodology and assumptions used; (3) ways to enhance
the quality, utility, and clarity of the information to be collected;
and (4) ways to minimize the burden of the collection of information on
respondents, including the use of automated, electronic, mechanical, or
other technological collection techniques or other forms of information
technology.
All comments received in response to this notice, including names
and addresses when provided, will be a matter of public record.
Comments will be summarized and included in the submission request
toward Office of Management and Budget approval.
Dated: November 21, 2008.
Robin L. Thompson,
Associate Deputy Chief, State and Private Forestry.
[FR Doc. E8-28343 Filed 11-26-08; 8:45 am]
BILLING CODE 3410-11-P
