U.S. Department of Labor 

Mine Safety and Health Administration 

MSHA’s Education Field & Small Mine Services

Serving the Mines and Contractors in America

1
Table of Contents

Page

Records Schedule.......................................................................................... 3

Part 41 Legal Identity .................................................................................... 5

Part 45 Independent Contractor ................................................................... 6

Part 46 Training Plan ..................................................................................... 14

Part 46 Training Records ............................................................................... 15

Part 47 HAZCOM........................................................................................... 27

Part 50 Immediate Notification..................................................................... 35

Part 50 Accident Reporting ........................................................................... 38

Part 50 Quarterly Reporting.......................................................................... 45

Part 56 Surface M/NM Standards ................................................................. 52

56.1000 Commencement Notice .................................................................. 54

56.4201 Fire Fighting Equipment .................................................................. 57

56.4330 Evacuation Plan............................................................................... 60

56.5002/5005 Exposure Monitoring and Controls ........................................ 62

Respiratory Protection Program.................................................................... 66

56.12028 Continuity and Resistance ............................................................. 74

56.13017 Air Compressor Inspection ............................................................ 78

56.14100 Mobile Equipment......................................................................... 80

56.18002 Workplace Exam ............................................................................ 87

56.18010 First Aid ......................................................................................... 88

Part 62 Occupational Noise ........................................................................... 89

Part 100 Criteria for Penalties ....................................................................... 98

Self Audit ...................................................................................................... 99

Top 20 Citations by Mine Type ...................................................................... 99

Guarding ....................................................................................................... 107

Miner Rights ................................................................................................. 108

Holmes Safety ............................................................................................... 109

Education Field and Small Mine Services ...................................................... 110

State Grants .................................................................................................. 111

Additional Resources .................................................................................... 112

This supplement is to serve as a compliance guide for the Part 46 mining industry. It is not an all inclusive document of the 30 CFR

requirements and it is imperative that mine operators, miners, and contractors familiarize themselves with all applicable regulations.
RECORDS to be maintained and/or submitted by the Mine Operator and

Contractor, subject to MSHA Inspector review

Required to be kept and to be submitted to MSHA

1. Part 41 Review the accuracy of Legal Identity form; submit changes within 30 

days

2. MSHA 7000-1 Accident/Injury/Illness Report (submit within 10 working days)

3. MSHA 7000-2 Quarterly Employment Report (due within 15 days after the end of each

calendar quarter)

Required to be kept

1. 56/57.12028 Documentation of Continuity and Resistance of Electrical Equipment

Grounding tests

2. 56/57.14100 Pre-Shift Mobile Equipment Defects and Repairs. Documentation of

defects not immediately repaired.

3. 56/57.18002 Documentation of Examination of working places by a competent person

EACH shift

4. 56/57.18010 Documentation for currently-trained individual capable of providing

first-aid assistance on all working shifts

5. 56.57/.4201 Documentation of firefighting equipment inspections, including monthly 

visual checks and annual maintenance check

6. Part 45 List of Independent Contractors

7. Part 46 Training Plan and Training Certificates

8. Part 47 Hazard Communication Program

Required to be kept under specific circumstances

1. 56/57.5005 Respiratory Protection Program/Fit-testing. Required by MSHA when 

an overexposure is found

2. 56/57.13015 Pressure Vessel/Boiler Certification

3. Part 62 Hearing Conservation Program. Required if exposure is above the 

“action level”

4. ATF Required Documents

3
Suggested “Calendar” for Required MSHA Tasks

What When Due Done

Annual Refresher Training 

(46.8)

Annually

Certify employee Task Tr. 

Certificates (46.9(d)(3)

Annually, at minimum

Re-train the employee first aid 

provider(s) (56.18010)

As specified by first 

aid training provider

Documented Site-Specific 

Training for “miners” who move 

to another mine site while 

employed by the same mine 

operator or independent 

contractor (46.11( c) )

Before beginning 

work at the new mine 

site

Hearing Conservation Program 

Training (62.180)

Annually

(if required)

Hearing Conservation Program 

Audiometric Testing offered to 

employees (62.170)

Annually

(if required)

Electrical system grounding 

tests (56.12028) 

Annual (at minimum) 

– or upon installation,

repair, modification or

portable plant move.

Visual inspection of fire 

extinguishers (56.4201)

Monthly

Maintenance check of fire 

extinguishers (56.4201)

Annually

Notification of mine 

commencement or closure 

(56.1000)

Initial startup or 

moving (portable 

plant) or seasonal 

start-up or seasonal 

closure or permanent

closure.

Quarterly Employment Report 

(50.30). Keep for five years

Within 15 days after 

the end of each 

calendar quarter.

No later than:

1/15

4/15

7/15

10/15

Examination of Working Places 

(56.18002). Keep for 1 yr.

Each working place 

each working shift.

Pre-use inspection of mobile 

equipment and any equipment, 

machinery and tools 

(56.14100)

Inspected before 

placed or used in 

operation

Notification of “Accident”

(50.10)

1-800-746-1553

Within 15 minutes of 

knowledge of the 

“accident”

Report injuries, illnesses and 

“accidents” on Form 7000-1 

(50.20). Internal investigation 

and report (50.11). Keep both 

for 5 years.

Within 10 working 

days of occurrence or 

diagnoses

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LEGAL IDENTITY

 30 CFR § 41.10 Scope. 

Section 109(d) of the Federal Mine Safety and Health Act of 1977 (Pub. L. 91-173, as 

amended by Pub. L. 95-164), requires each operator of a coal or other mine to file with 

the Secretary of Labor the name and address of such mine, the name and address of the 

person who controls or operates the mine, and any revisions in such names and addresses. 

Section 103(h) of the act requires the operator of a coal or other mine to provide such 

information as the Secretary of Labor may reasonably require from time to time to enable 

the Secretary to perform his functions under the act. The regulations in this Subpart B 

provide for the notification to the Mine Safety and Health Administration of the legal 

identity of the operator of a coal or other mine and the reporting of all changes in the 

legal identity of the operator as they occur. The submission of a properly completed 

Legal Identity Report Form No. 2000-7 required under Subpart C of this part will 

constitute adequate notification of legal identity to the Mine Safety and Health 

Administration. 

Mine Operators or Contractors May Now File Required Identity Information at the 

following links

Mine ID Request

Legal ID Report

Contractor ID Request

Federal regulations require that every mine operator submit information that includes the 

name, and address of the mine, the name and address of the person who controls or 

operates the mine, as well as any changes to this information, to MSHA in a prompt 

manner. Previously, it was required that mine operators file the legal identity report and 

every change of any information contained in that report, to MSHA by properly 

completing MSHA form 2000-7 and mailing or otherwise delivering the form to the 

appropriate agency district office. 

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INDEPENDENT CONTRACTOR 

30 CFR § 45.1 Scope and purpose. 

This part sets forth information requirements and procedures for independent contractors to obtain an MSHA identification number 

and procedures for service of documents upon independent contractors. Production-operators are required to maintain certain 

information for each independent contractor at the mine. The purpose of this rule is to facilitate implementation of MSHA's 

enforcement policy of holding independent contractors responsible for violations committed by them and their employees.

30 CFR § 45.2 Definitions. 

As used in this part: 

(a) Act means the Federal Mine Safety and Health Act of 1977, Pub. L. 91-173, as amended by Pub. L. 95-164;

(b) District Manager means the District Manager of the Mine Safety and Health Administration District in which the independent

contractor is located;

(c) Independent contractor means any person, partnership, corporation, subsidiary of a corporation, firm, association or other

organization that contracts to perform services or construction at a mine; and,

See MSHA's Program Policy Manual

(d) Production-operator means any owner, lessee, or other person who operates, controls or supervises a coal or other mine.

30 CFR § 45.3 Identification of independent contractors.

(a) Any independent contractor may obtain a permanent MSHA identification number. To obtain an identification number, an

independent contractor shall submit to the District Manager in writing the following information:

(1) The trade name and business address of the independent contractor;

(2) An address of record for service of documents;

(3) A telephone number at which the independent contractor can be contacted during regular business hours; and

(4) The estimated annual hours worked on mine property by the independent contractor in the previous calendar year, or in the

instance of a business operating less than one full calendar year, prorated to an annual basis.

30 CFR § 45.4 Independent contractor register.

(a) Each independent contractor shall provide the production-operator in writing the following information:

(1) The independent contractor's trade name, business address and business telephone number;

(2) A description of the nature of the work to be performed by the independent contractor and where at the mine the work is to

be performed;

(3) The independent contractor's MSHA identification number, if any; and

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INDEPENDENT CONTRACTOR 

(4) The independent contractor's address of record for service of citations, or other documents involving the independent

contractor.

(b) Each production-operator shall maintain in writing at the mine the information required by paragraph (a) of this section for

each independent contractor at the mine. The production-operator shall make this information available to any authorized

representative of the Secretary upon request.

30 CFR § 45.5 Service of documents; independent contractors.

Service of citations, orders and other documents upon independent contractors shall be completed upon delivery to the independent 

contractor or mailing to the independent contractor's address of record. 

30 CFR § 45.6 Address of record and telephone number; independent contractors.

(a) The address and telephone number required under this part shall be the independent contractor's official address and telephone

number for purposes of the Act. Service of documents upon independent contractors may be proved by a Post Office return receipt

showing that the documents were delivered to the address of record or that the documents could not be delivered to the address of

record because the independent contractor is no longer at that address and has established no forwarding address; because delivery

was not accepted at that address; or because no such address exists. Independent contractors may request service by delivery to

another appropriate address of record provided by the independent contractor. The telephone number required under this part will

be used in connection with the proposed penalty assessment procedures in 30 CFR part 100.

PROGRAM POLICY MANUAL 

III. 45-1 General Enforcement Policy for Independent Contractors

MSHA's policy is to issue citations and, where appropriate, orders to independent contractors for violations of applicable provisions of 

the Act, standards or regulations. This policy is based on the Mine Act's definition of an "operator," which includes "independent 

contractors performing services or construction" at mines. 

MSHA's enforcement policy regarding independent contractors does not change production-operators' basic compliance

responsibilities. Production-operators are subject to all provisions of the Act, and to all standards and regulations applicable to their 

mining operations. This overall compliance responsibility includes assuring compliance by independent contractors with the Act and 

with applicable standards and regulations. As a result, both independent contractors and production-operators are responsible for 

compliance with all applicable provisions of the Act, standards and regulations. 

7
INDEPENDENT CONTRACTOR 

This "overlapping" compliance responsibility means that there may be circumstances in which it is appropriate to issue citations or 

orders to both the independent contractor and to the production- operator for a violation. Enforcement action against a productionoperator for a violation(s) involving an independent contractor is normally appropriate in any of the following situations: (1) when the 

production-operator has contributed by either an act or by an omission to the occurrence of a violation in the course of an independent 

contractor's work; (2) when the production-operator has contributed by either an act or omission to the continued existence of a 

violation committed by an independent contractor; (3) when the production-operator's miners are exposed to the hazard; or (4) when 

the production-operator has control over the condition that needs abatement. In addition, the production-operator may be required to 

assure continued compliance with standards and regulations applicable to an independent contractor at the mine. 

Inspectors should cite independent contractors for violations committed by the contractor or by its employees. Whether particular

provisions apply to independent contractors or to the work they are performing will be apparent in most instances. However, some 

provisions of the Act, standards or regulations may not be directly applicable to independent contractors or their work; or independent 

contractor compliance with certain standards or regulations may duplicate the production-operator's compliance efforts. As questions 

regarding such matters arise, the inspector's supervisor shall contact the district manager, who shall consult with the Administrator's

Office. 

The following guidelines cover the responsibility of independent contractors for compliance with 30 CFR Parts 41, 48 and 50. 

1. Filing of Legal Identity Reports Under 30 CFR Part 41

Independent contractors working at mines are not required to file legal identity reports under Part 41. Procedures for the

identification of independent contractors are explained below under 45.3, MSHA Identification of Independent Contractors.

2. Training of Independent Contractors and Their Employees Under 30 CFR Part 48

a. Construction Workers

See Part 48 in this Manual, Paragraphs 48.2(a)(1)/48.22(a)(1) - "Miner."

b. Comprehensive and Hazard Training

See Part 48 in this Manual.

c. Production of Training Records

Independent contractors required to provide training are also required to promptly produce training records to show that

training has been provided. The location where the records are maintained, such as at a mine site, or at the contractor's office,

is up to the independent contractor.

d. Enforcement Action for Training Violations

1.) General

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INDEPENDENT CONTRACTOR 

An order should be issued under Section 104(g) of the Act to the direct employer of any miner who has not received the 

required training under Part 48. This means that a 104(g) order should be issued to the independent contractor for any 

persons who are directly employed by the independent contractor and who are not properly trained. Similarly, a 104(g) 

order should be issued to the production-operator for any untrained persons directly employed by the production- operator. 

See also Item 3), below. In addition, it is the policy of Coal Mine Safety and Health to issue a corresponding citation to the 

independent contractor or production operator for failure to provide the miner with the requisite training.

2.) Violations Involving Production-Operators

Each production-operator is required to have an approved training plan under Part 48 and to comply with the provisions of 

that plan in training each of the miners it employs. As discussed in Item 3), below, where it cannot be determined who 

employs an untrained person, the production-operator should be issued a 104(g) order for that person. 

3.) Violations Involving Independent Contractors

Independent contractors are not required to have an approved training plan under Part 48. However, as discussed, 

independent contractors and their employees must be trained in accordance with Part 48. Independent contractors may 

comply with the training requirements by either making arrangements to have their employees trained under an existing 

approved training plan and program, or by filing and adopting their own approved training plan. 

In either event, the independent contractor should be issued a 104(g) order for any of his/her employees who are not trained 

in accordance with a plan approved under Part 48. Care should be taken when issuing a 104(g) order to an independent 

contractor when several contractors or subcontractors are present at the mine. The inspector must be sure that the untrained 

person is directly employed by the independent contractor to whom the 104(g) order is issued. If it cannot be determined 

who employs the untrained person, the production-operator should be issued the 104(g) order.

The foregoing enforcement guidelines for 30 CFR Part 48 are consistent with the training standard's purpose to assure that all persons 

at mines are effectively trained in matters affecting their health and safety, thereby reducing the number and severity of injuries. These 

guidelines recognize that not all independent contractors are able to practically implement their own Part 48 training 

programs. Accordingly, independent contractors may comply with the training requirements in the manner most suitable for their size 

and type of business by making arrangements to have their employees trained under an existing approved plan or by filing and

adopting their own approved plans.

9
INDEPENDENT CONTRACTOR 

3. Notification, Investigation, Reporting and Recordkeeping Requirements Under 30 CFR Part 50

Independent contractors working at mines are required to comply with all provisions of Part 50 pertaining to their employees. In order

to assure accurate reporting and recordkeeping and to avoid duplication, it is important that production-operators and their

independent contractors carefully coordinate their Part 50 responsibilities.

For detailed information on the reporting responsibilities and obligations of independent contractors, see Part 50 in this Manual. 

45.2(c) Definition of Independent Contractor 

The Mine Act defines an independent contractor as "any person, partnership, corporation, subsidiary of a corporation, firm, 

association or other organization that contracts to perform services or construction at a mine." If the "person, partnership, ... or other 

organization" contracts for the production of a mineral, the "person, partnership, ... or other organization" is classified as a mine 

operator, and it is required to file a Legal Identity Report. In addition, it will be assigned a mine identification number, and it is subject 

to all requirements applicable to a mine operator. 

45.3 MSHA Identification of Independent Contractors 

Any independent contractor that requests an identification number will receive one from MSHA. However, unless cited for a 

violation, only those independent contractors performing work at mine sites, or with contracts to perform at a mine(s) any of the nine 

types of services or construction listed below, are required by MSHA to have identification numbers: 

1. Mine development, including shaft and slope sinking;

2. Construction or reconstruction of mine facilities; including building or rebuilding preparation plants and mining equipment, and

building additions to existing facilities;

3. Demolition of mine facilities;

4. Construction of dams;

5. Excavation or earthmoving activities involving mobile equipment;

6. Equipment installation, such as crushers and mills;

7. Equipment service or repair of equipment on mine property for a period exceeding five consecutive days at a particular mine;

8. Material handling within mine property; including haulage of coal, ore, refuse, etc., unless for the sole purpose of direct removal

from or delivery to mine property; and

9. Drilling and blasting.

10
INDEPENDENT CONTRACTOR 

MSHA does not require independent contractors to have identification numbers as a precondition to bidding for work contracts on 

mine property. If an independent contractor becomes a successful bidder and if the contract to be performed covers any of the nine 

types of service or construction listed above, the contractor must obtain an identification number. 

MSHA identification numbers have no effect on the compliance responsibility of either the mine operator or the independent 

contractor. Mine operators have compliance responsibility for all activities at the mine, regardless of whether or not the independent

contractor in question has an MSHA identification number. The mine operator's overall compliance responsibility includes assuring 

each independent contractor's compliance with the Act and with MSHA's standards and regulations. Independent contractors are 

responsible for compliance with applicable provisions of the Act, standards and regulations, regardless of whether or not they have an

MSHA identification number. 

Whenever an independent contractor submits a written request for an identification number, the contractor must furnish the 

information listed under 30 CFR 45.3(a). If an independent contractor cited for a violation does not have an MSHA 

identification number, the inspector should obtain the information required by 30 CFR 45.3(a) from the independent 

contractor. Information required under 30 CFR 45.3(a)(1), (2) and (3) may also be obtained from the production-operator (see 30 

CFR 45.4(b)). 

Each independent contractor who has an identification number uses it on all job sites. In the event of a change in ownership (but 

same trade name), a new identification number should be assigned. This means that each independent contractor is assigned 

only one identification number to be used on any and all job sites. 

45.4 Independent Contractor Register 

30 CFR 45.4(a) requires independent contractors to provide production-operators with minimal information necessary to the 

conduct of an MSHA inspection. 30 CFR 45.4(b) requires production-operators to maintain this information in written form at the 

mine, and to make the information available to an inspector upon request. 

In order to accomplish this purpose, both the independent contractor and the production-operator have responsibilities under 

Section 45.4(a). In the event that an independent contractor refuses to provide the production-operator with the necessary 

information, the contractor is subject to citation for failure to comply with Section 45.4(a). In addition, if a production-operator 

refuses to make the necessary information available to the inspector, he or she is subject to citation for violation of Section 45.4(b). 

However, there may be instances where the information required by Section 45.4 is not immediately available due to an inadvertent 

omission which is quickly corrected. For example, where contracts are kept at the mine's central or headquarters office, and 

a particular independent contractor has begun work on the mine property without the knowledge of the local mine, the inspector 

should consider all factors relevant to the particular case. If the necessary information can be secured in a reasonable time, no 

violation for failure to keep an accurate register should be found to exist. 

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INDEPENDENT CONTRACTOR 

In all cases, it should be kept in mind that Section 45.4 is intended to give the inspector sufficient information so that a fair and 

efficient inspection can be made. If that information promptly is made available to the inspector so that this goal can be accomplished, 

then there is no violation of Section 45 

12


Link to Part 46 Training Regulations

14

Part 46

Link to Part 46 Training Plan

Part 48

Link to Part 48 Training Regulations

Link to Part 46 & Part 48 Online 

Training Plan Advisor
30 CFR § 46.9 Records of Training 

(a) You must record and certify on MSHA Form 5000-23, or on a form that contains the information

listed in paragraph (b) of this section, that each miner has received training required under this

part.

(b) The form must include:

(1) The printed full name of the person trained;

(2) The type of training, the duration of the training, the date the training was received, the name

of the competent person who provided the training:

(3) The name of the mine or independent contractor, MSHA mine identification number or

independent contractor identification number, and location of training (if an institution, the

name and address of the institution).

(4) The statement, "False certification is punishable under § 110(a) and (f) of the Federal Mine

Safety and Health Act," printed in bold letters and in a conspicuous manner; and

(5) A statement signed by the person designated in the MSHA-approved training plan for the mine

as responsible for health and safety training, that states "I certify that the above training has

been completed."

(c) You must make a record of training under paragraphs (b)(1) through (b)(4) of this section.

(1) For new miner training under §46.5, no later than

(i) when the miner begins work at the mine as required under § 46.5(b);

(ii) 60 calendar days after the miner begins work at the mine as required under § 46.5(c);

and

(iii) 90 calendar days after the miner begins work at the mine as required under § 46.5(d), if

applicable.

(2) For newly hired experienced miner training under §46.6, no later than

(i) when the miner begins work at the mine; and

(ii) 60 calendar days after the miner begins work at the mine.

(3) Upon completion of new task training under §46.7;

(4) After each session of annual refresher training under §46.8; and

(5) Upon completion by miners of site-specific hazard awareness training under §46.11.

(d) You must ensure that all records of training under paragraphs (c)(1) through (c)(5) of this section

are certified under paragraph (b)(5) of this section and a copy provided to the miner

(1) Upon completion of the 24 hours of new miner training;

(2) Upon completion of newly hired experienced miner training;

(3) At least once every 12 months for new task training, or upon request by the miner, if

applicable;

(4) Upon completion of the 8 hours of annual refresher training; and

(5) Upon completion by miners of site-specific hazard awareness training.

(e) False certification that training was completed is punishable under § 110(a) and (f) of the Act.

(f) When a miner leaves your employ, you must provide each miner with a copy of his or her training

records and certificates upon request.

15

Link to 5000-23 Training Record
(g) You must make available at the mine a copy of each miner's training records and certificates for

inspection by us and for examination by miners and their representatives. If training certificates are

not maintained at the mine, you must be able to provide the certificates upon request by us, miners,

or their representatives.

(h) You must maintain copies of training certificates and training records for each currently employed

miner during his or her employment, except records and certificates of annual refresher training

under §46.8, which you must maintain for only two years. You must maintain copies of training

certificates and training records for at least 60 calendar days after a miner terminates employment.

(i) You are not required to make records under this section of site-specific hazard awareness training

you provide under §46.11 of this part to persons who are not miners under §46.2. However, you

must be able to provide evidence to us, upon request, that the training was provided, such as the

training materials that are used; copies of written information distributed to persons upon their

arrival at the mine; or visitor log books that indicate that training has been provided.

Program Policy Manual 

§ 46.9 Records of Training

Part 46 requires that operators record and certify the training that miners receive. Recording means

creating a written record of the training. The record must include: 

• the full name of the person trained;

• the type of training;

• duration of training;

• the date the training was received;

• the name of the competent person who provided the training;

• name of mine or independent contractor;

• MSHA mine identification or independent contractor number (if applicable); and

• location of training (if an institution, the name and address of institution).

Certifying means verifying, by signature, that the training listed on the written record was completed 

as indicated on the form. Part 46 requires that this certification be done by the person who has been 

designated by the operator as responsible for health and safety training at the mine and whose name 

appears on the training plan. Certifying is required at the completion of training, such as at the end of 

the 24 hours of new miner training. 

Training records must be certified at: 

• the completion of new miner training;

• the completion of newly hired experienced miner training;

• the completion of the 8 hours of annual refresher training;

• least once every 12 months for new task training or upon request by the miner; and

• the completion of Site-specific Hazard Awareness Training for miners

16
A training record or certificate may be maintained in any format, provided that it contains the 

information listed in § 46.9(b). A "Certificate of Training Form" (MSHA Form 5000-23) may also be 

used. If a MSHA Form 5000-23 is used it must list the competent instructor(s) who conducted the 

training, the duration of the training and that the training is for Part 46. 

MSHA has developed a sample form which can be used. Both the sample form and the MSHA Form 

5000-23 are available from MSHA's Internet Home Page (www.msha.gov), from MSHA's Educational 

Field Services Division, or from MSHA District and Field offices. 

Under § 46.9(b), the records of training must include the name of the competent person who provided 

the training. If more than one competent person provided the training, the names of all persons must be 

included. 

It is acceptable to list more than one miner on a record or certificate of training. Part 46 allows 

operators flexibility in choosing the appropriate form for records of training, provided that the form 

used includes the minimum information specified in § 46.9(b)(1) through (b)(5). 

The person who has been designated by the operator or independent contractor as responsible for 

health and safety training is required to certify, by signature, that training has been completed. This 

should not be confused with the "competent person" who conducts the training. For example, a state, 

vocational school or cooperative instructor listed in a training plan may conduct the training and be 

recorded as the competent person for each subject they teach. The person, who is designated as the 

person responsible for Part 46 as indicated on the training plan, must certify that the training was 

completed. 

Fillable Part 46 Records of Training 

https://www.msha.gov/sites/default/files/Training_Education/Part46/Part46TrainingRecordsCertificate

s.pdf

Making Records Available to MSHA

A copy of each miner's training records and certificates must be made available for inspection by 

MSHA and for examination by miners and their representatives. This includes both certified training 

records and records that have not yet been certified. 

Maintaining Training Plans and Records

Operators and contractors must make available for inspection by MSHA and by miners and their 

representatives training plans, training records and certificates (§ 46.9 (g)). If the training plan, 

training records or certificates are not physically kept at the mine site, they must be "produced upon 

request;" such as by having them sent from another location via fax machine or computer. Training 

plans must be made available within one business day, but training records, and certificates with the 

signature of the person responsible for health and safety training must be made available before 

inspection activity at the mine concludes for the day. The reason for the difference is a matter of 

urgency. If a miner is untrained or improperly trained, it is a hazard to the miner and to other miners. 

17
Training records and certificates must be made available to the inspector at the mine site. The 

inspector may choose, as a matter of convenience, to inspect the records at the office or location where 

the records are maintained or have them faxed to an MSHA office for his or her inspection that day. 

Training Certificates for People who are not Considered Miners

A record of training is not required for Site-specific Hazard Awareness Training for persons who are 

not miners under § 46.2. However, operators must be able to provide evidence to us, upon request, that 

the training, when applicable, was provided. This evidence may include the training materials used, 

including appropriate warning signs, written information distributed to persons, or a visitor log book 

that reflects that Site-specific Hazard Awareness Training has been given.

18
NEW MINER TRAINING RECORD/CERTIFICATE

Miners Full Name (Print) _____________________________

Mine or Contractor Name ID# 

Subject

30 CFR Part 46.5

Course

Length

Date Competent 

Person

Location (Name & 

Address if Institution)

Miners 

Initials

The miner received no less than 4 hours training in the following, before beginning work:

(b) (1) Introduction to work

environment, mine tour, mining 

method/operation

(b)(2) Instruction on recognition and 

avoidance of electrical and other 

hazards

(b)(3) Emergency procedures, escape, 

and firefighting

(b)(4) Health and safety aspects of 

tasks assigned. 

Part 47 HazCom Program.

(b)(5) Instruction on statutory rights of 

miners and their representatives

(b)(6) Authority & responsibility of 

supervisors and miners=

representatives

(b)(7) Introduction to your rules and procedures for reporting hazards

No later than 60 days:

(c)(1) Self-rescue, respiratory devices, 

if used

(c)(2) First aid

No later than 90 days (balance of 24 hours including the following subjects):

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act

I certify that the above training has been completed 

____________________________________________________________________________________________________________

(Signature of person responsible for health and safety training) (Date)

19
NEWLY-HIRED EXPERIENCED MINER TRAINING 

RECORD/CERTIFICATE

Miners Full Name (Print) ________________________________

Mine or Contractor Name ID#

Subject

30 CFR Part 46.6

Course 

Length

Date Competent 

Person

Location

(Name & Address if 

Institution)

Miners 

Initials

The miner has received the following training before beginning work: 

(b)(1) Introduction to work 

environment, mine tour, mining 

method/operation

(b)(2) Instruction on recognition and 

avoidance of electrical and other 

hazards

(b)(3) Emergency procedures, escape, 

and firefighting

(b)(4) Health and safety aspects of 

tasks assigned. HazCom Program.

(b)(5) Instruction on statutory rights 

of miners and their representatives

(b)(6) Authority & responsibility of 

supervisors and miners

representatives

(b)(7) Introduction to your rules and procedures for reporting hazards

Part 47 HazCom Program

No later than 60 days:

(c) Self-rescue, respiratory devices, if

used

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act

I certify that the above training has been completed

____________________________________________________________________________________________________________ 

(Signature of person responsible for health and safety training) (Date)

20
NEW TASK TRAINING RECORD/CERTIFICATE

Miners Full Name (Print) ______________________________

Mine or Contractor Name ID#

New Task

30 CFR Part 46.7

Duration 

of 

Training

Date Competent 

Person

Location 

(Name & Address if Institution)

The miner received the following training before performing a new task, or a change occurred in an assigned task that affects health 

and safety risk. Includes HAZCOM training

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act

I certify that the above training has been completed 

____________________________________________________________________________________________________ 

(Signature of person responsible for health and safety training) (Date)

21
ANNUAL REFRESHER TRAINING RECORD/CERTIFICATE

Miners Full Name (Print)_______________________________

Mine or Contractor Name ID# 

Subject

30 CFR Part 46.8

Subject

Length

Date Competent 

Person

Location 

(Name & Address if 

Institution)

Miners 

Initials

The miner received no less than 8 hours of annual refresher training in the following:

Changes at the mine that 

affect the miners’ health or 

safety.

(For recommended subjects see 46.8 (c))

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act

I certify that the above training has been completed 

___________________________________________________________________________________________________ (Signature 

of person responsible for health and safety training) (Date)

22
SITE-SPECIFIC HAZARD AWARENESS TRAINING 

RECORD/CERTIFICATE

Miners Full Name (Print)_______________________________

Mine or Contractor Name ID# 

Location: 

Length of Training: ________________________

Date Training Provided: _________________________ 

Competent Person Providing the Training: _________________________ 

Miners Initials: _________________________ 

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act 

I certify that the above training has been completed 

___________________________________________________________________________________________________ 

(Signature of person responsible for health and safety training) (Date)

23
El. . ll iER TB.AINI C RECORD /CERTIFICATE 

NinenFull ame(Print) tlobb SMit'n Dae. 

oritontr aor m· Lucky Dog Hole 7 m• 0000000 

Sabjert Course Date 

lO Ci'R iP11n -io.S l�ll�

Ur.a-... l"n'lrlfnil-b •• 

3 hours 8/30/13 Jack Trades. Office, Mine Site 

2 hours 8/30/13 Jack Trades I Offke, Mi rte Site

2 hours 9/3/13 JadkTrades Office, Mine Site 

4 hours 9/3/13 J aok Trad es Office, Mine Site 

1 hour 91

/3/13 JaokTrades. I Office, Mine Site

1 hour 9/4/13 Jack Trades Offic, e, Mine Site 

1 hour 9/4/13 Jack Trad es Office, Mine Site 

1 hour 9/12/13 J aok Trad es Office, Mine Site J:1) 

.Cl(l.l 2 hours 9/21/13 Jack Trad es Offioe J1) 

Ur 

46.5, [d� 0. J. T. 4 hours 9/S/13 Jack Trad es Mine Site, J1) 

46.S [d� 0. J. T. 3 hours 9/6/13 Jao'kTrades. Mine Site, j1) 

24
Site Specific Hazard Awareness Training Checklist Example

Persons delivering goods, performing services, collecting material, or visiting and inspecting this property, and who are not regular employees may encounter certain hazards 

during that time. Visitors to this property are subject to the requirements of either the Federal Mine Safety and Health Act of 1977, as well as any Company Safety procedures 

or rules. All Contractors/Subcontractors performing services on mine properties are responsible for compliance with Part 46 of the Code of Federal Regulatins (CFR 30) for 

Mineral Resources.

During your time on our property, observe all posted rules and regulations, including speed limits, and carefully follow all verbal instructions given by plant management or 

other authorized personnel. Immediately report to plant supervisory personnel any unlisted hazard you may encounter. Your access is limited to designated areas. You are not 

cleared or trained for other areas at this facility.

HAZARDS YOU MAY 

ENCOUNTER

PROCEDURES/RULES FOR AVOIDING INJURY

Moving Equipment Be alert and remain clear of moving equipment. Make sure the operator knows you are there. Be aware of any 

special traffic or driving hazards. Never park in front of or behind stationary equipment. 

Power Lines Note position of overhead power lines. Do not operate lifting devices within 10 feet of overhead lines.

Parking Self propelled equipment transmissions must be placed in the “park” position, parking brake set, and the wheels 

must be either chocked or turned into a bank when parked. This applies to wheeled and track mounted 

equipment. 

Traffic Pattern Traffic pattern at this location is left hand from the front gate to the end of the stockpile area. Right hand rules 

apply on all pit haul roads. Heavy equipment always has the right-of-way. Speed limit around the office, shop, 

and on the main road and plant areas is 15 mph, and 35 mph on pit haul roads.

Right of Way Haul trucks, loaders, forklifts, and water trucks always have the right-of-way.

Moving Machinery Be alert and remain clear of moving machinery. Do not work around any moving machine or perform work on 

any machine that has not been stopped and blocked to make it safe from hazardous motion. If the machine is 

powered by electricity, the electrical power source must be off, locked out, and tagged.

Noise Wear hearing protection in posted areas and other areas if appropriate. 

PPE Wear safety glasses with side shields in all areas past the office. Use goggles or face shield when grinding, 

welding, cutting, or when using chemicals. Hard hats, steel toed boots and proper gloves are required when 

working.

Inspections All self propelled equipment must be inspected for defects before being placed in operation. Defects must be 

corrected in a timely manner. 

Tripping or Falling Exercise care when getting in and out of your vehicle and when stepping over or around any obstacle. Use 

handrails on stairs and walkways. Use fall protection where there is a danger of falling.

Injury from Lifting Use correct lifting procedures to avaid injury and enlist aid in lifting heavy or awkward objects.

Lock Out All equipment must be blocked against hazardous motion when performing maintenance. Electrical lockout 

procedures must be followed anytime maintenance is performed on electrically powered equipment or systems. 

Fire or Explosion Obey “No Smoking or Open Flame” signs in the areas where flammables exist. A fire extinguisher must be 

readily available when using torches or welders. Fires must be reported to management immediately.

Fumes/Exhaust Avoid areas where excessive welding fumes or engine exhausts are present until properly ventilated.

Welding Flash Avoid areas where operations are being conducted and do not look at flash.

Tools Plan your work. Always select and use the correct tool(s) for the work at hand. Do not use tools or equipment 

beyond their design capacity.

Weather Avoid working outside during extreme weather conditions such as thunderstorms, heavy rain, hail, or high 

winds. Make sure that snow and ice have been removed or covered with material to give a safe footing.

First Aid/Injuries First aid kits are located in the shop office, office bathroom an plant house. The stretcher is located in the shop 

and the blanket in the office bathroom. Eye wash stations are in the shop next to the office and in the plant house. 

All injuries must be reported immediately to site management.

Ground Control Do not attempt to enter any area where unsafe ground conditions or high walls exist. Mobile equipment in unsafe 

areas must be moved or towed to a safe area prior to servicing.

Seat Belts Where provided, seat belt usage is mandatory at all times on company property.

Life Jackets When traveling or working over water, coastguard approved life jackets must be available and used.

Customer Trucks Customers must remain in their vehicles or in a designated safe area during loading. Customers are not allowed 

to climb on truck beds while on mine property.

Emergency phones Emergency phones are located in the office. 

Emergency Procedures In the event of an emergency our designated assembly area is (see diagram on reverse side).

Your designated work area Refer to diagram on reverse side.

25
Site-Specific Hazard Awareness Training Record Example 

MINE NAME:

MSHA ID: 

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

Note: Upon entering this property. You agree to strictly abide by these rules. 

Any Deviation in any way from these rules, you will be removed from the property.

Full Name / Company (Print)

Company: MSHA ID 

Length of Training: 

Date Training Provided: 

Competent Person Providing the Training: 

 Signature: 

False certification is punishable under section 110 (a) and (f) of the 

Federal Mine Safety and Health Act 

I certify that the above training has been completed 

26
HAZARD COMMUNICATION PROGRAM

Company NAME: 

MSHA ID: 

47.32 (a) (1) Hazard Determination 

Each chemical brought on mine property and each chemical produced on mine property will be 

evaluated to determine if it is hazardous as specified in Table 47.21 (refer to Hazard 

Determination tab).

47.32 (a) (2) Labels and Other Forms of Warning

The labeling system at this mine is: (refer to Labeling tab)

Manufacturers’ Labels

Other Bulks tanks, Portable containers 

1. Container Labeling:

a. Product identifier

b. Signal word

c. Hazard statement(s)

d. Pictogram(s)

e. Precautionary statement(s); and

f. Name, address, and telephone number of the chemical manufacturer, importer, or other

responsible party

2. Solid Material Labeling

The Company will verify that all solid materials not exempted due to their downstream use; were

delivered with a label or received the label prior to the initial shipment, and need not be included

in subsequent shipments unless information on the label changes.

The Company will at each work site ensure that all secondary containers are labeled with either 

an extra copy of the original manufacturer’s label or with our company’s own labels which have: 

Product identifier, words, pictures, symbols or combination thereof, which provides at least 

general information regarding the hazards of the chemicals. For help with labeling contact the 

safety/health officer or Supervisor in charge.

47.32 (a) (3) Material Safety Data Sheets (MSDS)

This program includes a current, legible, and accessible Material Safety Data Sheet (MSDS) for 

each hazardous chemical at this mine site.

Manufacturers’ MSDS

27
MSDS will be accessible to miners during each work shift for each hazardous chemical to which 

they may be exposed either:

.At each work area where the hazardous chemical is produced or used

.At the mine office

3. Safety Data Sheets (SDS)

Copies of the SDSs for all hazardous chemicals to which employees of this

Company may be exposed will be available to all employees in their work area for review during

each work shift. If SDSs are not immediately available or new chemicals in use do not have an

SDS, please immediately contact the person in charge.

47.32 (a) (4) Miner Training

All miners will receive instruction about the physical and health hazards of chemicals in their 

work areas, the protective measures they can take against these hazards (personal protective 

equipment, Ventilation, warning signs, etc., and the contents of the mine’s HazCom program 

(47.2) 

4. Employee Training and Information

Prior to starting work each new employee of the company will attend a safety and health 

orientation and will receive information and training on the following: 

a. An overview of the requirements contained in the Hazard Communication standard, Section

1910.1200.

b. Chemicals present in the workplace operations.

c. Location and availability of our written hazard communication program, including our list

of hazardous chemicals, and Safety data sheets.

d. Physical, health, simple asphyxiation, combustible dust, and pyrophoric gas hazards, as well

as hazards not otherwise classified, of the chemicals in the work area.

e. Methods and observation techniques used to determine the presence or release of hazardous

chemicals in the work area.

f. How to lessen or prevent exposure to these hazardous chemicals through usage of control/work

practices and personal protective equipment.

g. Steps the company has taken to lessen or prevent exposure to these chemicals.

h. Safety emergency procedures to follow if they are exposed to these chemicals.

i. How to read labels on shipped containers, as well as workplace labeling systems and review

SDSs format and how to obtain appropriate hazard information.

After attending the training class, each employee will sign a form to verify that they attended the 

training, received our written materials, and understood this company’s policies on hazard 

communication. 

Prior to a new hazardous chemical being introduced into any section of this company, each 

employee of that section will be given information as outlined above. 

28
NOTE: The hazard communication standard only requires a list of all hazardous 

chemicals; however, it is felt that identifying the location and possible processes will aid the 

employer in carrying out the full program.

6. Hazardous Non-routine Tasks

Occasionally, employees are required to perform hazardous non-routine tasks. Prior to starting

work on such given projects, each affected employee will be given information by their

supervisor about hazardous chemicals to which they may be exposed during such activity.

This information will include: 

a. Specific chemical hazards

b. Protective/safety measures the employee can take

c. Measures the company has taken to lessen the hazards including ventilation, respirators,

presence of another employee, and emergency procedures.

7. Chemicals in Unlabeled Pipes

Work activities are often performed by employees in areas where chemicals are transferred 

through unlabeled pipes. 

a. The chemicals in the pipes

b. Potential hazards

c. Safety precautions which should be taken

8. Informing Contractors

It is the responsibility of the company to provide contractors (with employees) the following 

information: 

a. SDSs for hazardous chemicals to which they may be exposed while on the work site.

b. Precautions the employees may take to lessen the possibility of exposure by usage of

appropriate protective measures.

c. The labeling system used in the work place.

8. Informing Operators

It is the responsibility of the contractor to provide operators the following information: 

a. SDSs for hazardous chemicals to which they may be exposed while on the work site.

b. Precautions the employees may take to lessen the possibility of exposure by usage of

appropriate protective measures.

c. The labeling system used in the work place.

29
47.32 (c) (1) (2) Training for Other Operators

Other operators at this mine will be provided with access to MSDS and informed about 

hazardous chemicals, to which their miners can be exposed, the labeling system on the 

containers of these chemicals and appropriate protective measures.

30
#

Chemical/Common/Trade Name

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

31
#

Chemical/Common/Trade Name

34

3536

37

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52

53

54

55

56

57

58

59

60

61

62

63

64

65

66

32
Pictograms

Health Hazards

Environmental Hazards

Physical Hazards

33
Transportation Hazards

34
Immediately Reportable Accidents and Injuries

ONE CALL DOES IT ALL! 

Mine operators are required to immediately call MSHA's 

toll-free number at 1-800-746-1553 to notify MSHA of an 

immediately reportable accident. This single toll-free 

phone call is required by the Emergency Mine Evacuation 

Final Rule published in the Federal Register on December 

8, 2006, and is the only call that mine operators will need 

to make to notify MSHA. 

Mine operators must call immediately, but no later than 15 

minutes from the time they know or should know that an 

accident has occurred.

Reportable Accidents and Injuries are: 

1. A death of an individual at a mine;

2. An injury to an individual at a mine which has a reasonable potential to cause death;

3. An entrapment of an individual for more than thirty minutes or which has a reasonable potential to

cause death;

4. An unplanned inundation of a mine by a liquid or gas;

5. An unplanned ignition or explosion of gas or dust;

6. In underground mines, an unplanned fire not extinguished within 10 minutes of discovery; in

surface mines and surface areas of underground mines, an unplanned fire not extinguished within

30 minutes of discovery;

7. An unplanned ignition or explosion of a blasting agent or an explosive;

8. An unplanned roof fall at or above the anchorage zone in active workings where roof bolts are in

use; or, an unplanned roof or rib fall in active workings that impairs ventilation or impedes

passage;

9. A coal or rock outburst that causes withdrawal of miners or which disrupts regular mining activity

for more than one hour;

10. An unstable condition at an impoundment, refuse pile, or culm bank which requires emergency

action in order to prevent failure, or which causes individuals to evacuate an area; or, failure of an

impoundment, refuse pile, or culm bank;

11. Damage to hoisting equipment in a shaft or slope which endangers an individual or which

interferes with use of the equipment for more than thirty minutes; and

12. An event at a mine which causes death or bodily injury to an individual not at the mine at the time

the event occurs.

35
ONE CALL 

DOES IT ALL! 

Immediately Report Accidents to MSHA

at

1-800-746-1553

24 Hours a Day, 7 Days a Week, 365 Days a Year

IT’S THE LAW 

Beginning December 8, 2006, mine operators are required 

by the Emergency Mine Evacuation Final Rule to call MSHA 

Call Center at 1-800-746-1553 to notify MSHA of 

immediately reportable accidents. Mine operators are required 

to notify MSHA immediately, but in no case later than 15 

minutes after they know or should know an accident has 

occurred. For more information" visit www.msha.gov. 

36
REPORTING A MINE EMERGENCY

IN THE EVENT OF

A MINE EMERGENCY

OR

AN ACCIDENT REQUIRING IMMEDIATE NOTIFICATION

Call 1-800-746-1553

Operator Name

Federal Mine ID Phone Number

MSHA Field Office

District Office

Directions to the mine

Emergency Evac. Area

State Department of Mines Phone Number

OTHER EMERGENCY PHONE NUMBERS

Emergency Medical Service 911

Fire Department 911

State Highway Patrol 911

County Sheriff 911

Ambulance 911

Hospital 911

Life Flight 911

Poison Control Center 1-800-222-1222

Latitude

Longitude

37
ACCIDENT REPORTING

30 CFR § 50.10 Immediate notification.

 The operator shall immediately contact MSHA at once without delay and within 15 minutes 

at the toll-free number, 1-800-746-1553, once the operator knows or should know that an 

accident has occurred involving: 

(a) A death of an individual at the mine;

(b) An injury of an individual at the mine which has a reasonable potential to cause death;

(c) An entrapment of an individual at the mine which has a reasonable potential to cause death;

or

(d) Any other accident.

30 CFR § 50.11 Investigation. 

(a) After notification of an accident by an operator, the MSHA District Manager will promptly

decide whether to conduct an accident investigation and will promptly inform the operator of his

decision. If MSHA decides to investigate an accident, it will initiate the investigation within 24

hours of notification.

(b) Each operator of a mine shall investigate each accident and each occupational injury at the

mine. Each operator of a mine shall develop a report of each investigation. No operator may use

Form 7000-1 as a report, except that an operator of a mine at which fewer than twenty miners are

employed may, with respect to that mine, use Form 7000-1 as an investigation report respecting

an occupational injury not related to an accident. No operator may use an investigation or an

investigation report conducted or prepared by MSHA to comply with this paragraph. An operator

shall submit a copy of any investigation report to MSHA at its request. Each report prepared by

the operator shall include,

(1) The date and hour of occurrence;

(2) The date the investigation began;

(3) The names of individuals participating in the investigation;

(4) A description of the site;

(5) An explanation of the accident or injury, including a description of any equipment involved

and relevant events before and after the occurrence, and any explanation of the cause of any

injury, the cause of any accident or cause of any other event which caused an injury;

(6) The name, occupation, and experience of any miner involved;

38
(7) A sketch, where pertinent, including dimensions depicting the occurrence;

(8) A description of steps taken to prevent a similar occurrence in the future; and

(9) Identification of any report submitted under §50.20 of this part.

30 CFR § 50.20 Preparation and submission of MSHA Report Form 7000-1--Mine 

Accident, Injury, and Illness Report.

(a) Each operator shall maintain at the mine office a supply of MSHA Mine Accident, Injury,

and Illness Report Form 7000-1. These may be obtained from the MSHA District Office. Each

operator shall report each accident, occupational injury, or occupational illness at the mine. The

principal officer in charge of health and safety at the mine or the supervisor of the mine area in

which an accident or occupational injury occurs, or an occupational illness may have originated,

shall complete or review the form in accordance with the instructions and criteria in §§50.20-1

through 50.20-7. If an occupational illness is diagnosed as being one of those listed in 

§50.20-6(b)(7), the operator must report it under this part. The operator shall mail completed 

forms to MSHA within ten working days after an accident or occupational injury 

occurs or an occupational illness is diagnosed. When an accident specified in §50.10 occurs, 

which does not involve an occupational injury, sections A, B, and items 5 through 12 of section 

C of Form 7000-1 shall be completed and mailed to MSHA in accordance with the instructions 

in §50.20-1 and criteria contained in §§50.20-4 through 50.20-6.

(b) Each operator shall report each occupational injury or occupational illness on one set of

forms. If more than one miner is injured in the same accident or is affected simultaneously with

the same occupational illness, an operator shall complete a separate set of forms for each miner

affected. To the extent that the form is not self-explanatory, an operator shall complete the form

in accordance with the instructions in §50.20-1 and criteria contained in §§50.20-2 through

50.20-7.

Link to 7000-1 Form

Link to Part 50 Accident Reporting Guide

39
Mine Accident, Injury and Illness Report

 Section A - Identification Data Approved For Use Through 1/31/2021 OMB No. 1219-0007

MSHA ID number Contractor ID Report Category Check here if report

Metal/Nonmetal Mining Coal Mining pertains to contractor

Mine name Company Name

 Section B - Complete for Each Reportable Accident Immediately Reported to MSHA

1. Accident Code (check applicable code - see instructions) 01 - Death 02 - Serious Injury 

05 - Gas or Dust Ignition

2. Name of investigator 3. Date investigation started 4. Steps taken to prevent recurrence of accident

month day year

 Section C - Complete for Each Reportable Accident, Injury or Illness

5. Check the codes which best describe where accident/injury/illness occurred (see instructions)

(a) Surface Location: 30 - Mill, Preparation Plant, etc. 03 - Strip/Open Pit Mine 04- Surface Auger Operation

17 - Independent Shops (with own MSHA ID) 99 - Office Facilities

02 - Slope/Inclined Shaft 04 - Intersection 05 - Underground Shop/Office 

08 - Other

6. Date of accident 7. Time of accident am 8. Time shift started am

pm pm month day year

9. Describe fully the conditions contributing to the accident/injury/illness, and quantify the damage or impairment

10. Equipment involved Type Manufacturer Model number

11. Name of witness to accident/injury/illness 12. Number of reportable injuries or illnesses

resulting from this occurrence

13. Name of injured/ill employee 14. Sex male 15. Date of birth

female month day year

16. Last four digits of 17. Regular job title 18. Check if this injury/ 19. Check if injury/illness resulted

Social Security number illness resulted in death in permanent disability (include

amputation, loss of use &

20. What directly inflicted injury or illness? 21. Nature of injury or illness permanent total disability)

22. Part of body injured or affected 23.

24. Employee’s work activity Experience Years Weeks

when injury or illness occurred 25. Experience in this job title

26. Experience at this mine

27. Total mining experience

 Section D - Return to Duty Information Answer 30 & 31 when case is closed

29. Date returned to

regular job at full 

capacity (or item 28)

30. Number of days

away from work

(if none enter 0)

28. Permanently transferred or

terminated (if checked, complete

items 29, 30, and 31)

31. Number of days

restricted work

activity (if none, enter 0)

month day year

Person completing form (name) Title

Date this report prepared (month, day, year) Area code and phone number

MSHA Form 7000-1, October 16 (revised)

7

8

10

Man

12

14

17

18

20

21

22

24

16

19

04 - Inundation

09 - Outburst 10 - Impounding Dam 11 - Hoisting

03 - Entrapment

06 - Mine Fire 07 - Explosives 

02 - Surface at Underground Mine

06 - Dredge Mining

01 - Vertical Shaft 03 - Face 06 - Other

(c) Underground Mining Method: 01 - Longwall 

02 - Shortwall

03 - Conventional Stoping

05 - Continuous Mining

06 - Hand

07 - Caving

Occupational illness (check applicable code - see instructions) 21 - Occupational Skin Diseases 

22 - Dust Diseases of the Lungs 24 - Poisoning (Toxic Materials)

25 - Disorders (Physical Agents) 

23 - Respiratory Conditions (Toxic Agents)

29 - Other

12 - Offsite Injury

12 - Other Surface Mining 

26 - Disorders (Repeated Trauma)

08 - Roof Fall

(b) Underground Location: 

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

05 - Culm Bank/Refuse Pile

For official use only

Degree

Accident Type

Accident Class

Scheduled Charge

Keyword

40
Section 50.20 of Part 50, Title 30, Code of Federal Regulations,

requires a report to be prepared and filed with MSHA of each accident, occupational injury, or occupational illness occurring at your

operation. The requirement includes all accidents, injuries, and illnesses as defined in Part 50 whether your employees or a contractor's employees are involved. A Form 7000-1 shall be completed

and mailed within ten working days after an accident or occupational injury occurs, or an occupational illness is diagnosed.

This report is required by law (30 U.S.C. §813; 30 C.F.R. Part

50). Failure to report can result in the institution of a civil action

for relief under 30 U.S.C. §818 respecting an operator of a coal

or other mine, and assessment of a civil penalty against an operator of a coal or other mine under 30 U.S.C. §820(a). An individual who, being subject to the Federal Mine Safety and Health 

Act of 1977 (30 U.S.C. §801 at seq.) knowingly makes a false 

state-ment in any report can be punished by a fine of not more 

than$10,000 or by imprisonment for not more than 5 years, or 

both, under 30 U.S.C. §820.(f). Any individual who knowingly 

and will-fully makes any false, fictitious, or fraudulent statements, 

con-ceals a material fact, or makes a false, fictitious, or 

fraudulent entry, with respect to any matter within the jurisdiction 

of any agency of the United States can be punished by a fine of 

not more than $10,000, or imprisoned for not more than 5 years, 

or both, under 18 U.S.C. §1001.

REPORTING INSTRUCTIONS

Form 7000-1 consists of four sheets, an original (page 1) and

three copies. The original will be mailed to MSHA, Office of Injury 

and Employment Information. The first copy (page 2) will be

mailed to the appropriate local MSHA District Office. If the 

mailed forms do not show return to duty information on an injured 

employee, complete and mail the second copy (page 3) to 

MSHA, Office of Injury and Employment Information, when the 

employee returns to regular job at full capacity or a final 

disposition is made on the injury or illness. The third copy

(page 4) is to be retained at the mine for a period of five years. It

is important to remember that a Form 7000-1 is required on each

accident as defined in 30 CFR Part 50 whether any person was

injured or not. A form is required on each individual becoming

injured or ill, even when several were injured or made ill in a single occurrence. The principal officer in charge of health and safety at the mine or the supervisor of the mine area in which the

accident, injury, or illness occurred shall complete or review the 

Form 7000-1. Note: First aid cases (those for which no medical 

treatment was received, no time was lost, and no restriction of 

work, motion, or loss of consciousness occurred) need not be 

reported.

SPECIFIC INSTRUCTIONS

Detailed instructions for completing Form 7000-1 are contained in

Part 50. A copy of Part 50 was sent to every active and intermittently active mine and independent mining contractor. If you do

not have a copy, you may obtain one from your local MSHA Mine

Safety and Health District or Field Office.

Section A- IDENTIFICATION DATA

Check the report category indicating whether your operation is in

the metal/nonmetal mining industry or the coal mining industry.

MSHA ID Number is the number assigned to the operation by

MSHA. If you are unsure of your number assignment, contact the

nearest MSHA Mine Safety and Health District or Field Office.

Reports on contractor activities at mines must include an MSHAassigned contractor ID Number as well as the 7-digit operation ID.

Show mine name and company name. Independent contractors

should show the contractor name under "company name. "

Section B- COMPLETE FOR EACH ACCIDENT IMMEDIATELY

REPORTABLE TO MSHA

Section B is to be completed only when your operation has an

accident that must be reported immediately to MSHA. Circle

code 02 "Serious Injury" only if the injury has a reasonable potential to cause death. For additional detail on those specific kinds of

accidents see Section 50.10 of Part 50. When it is necessary to

complete Section B, circle the applicable accident code; give the

name of the investigator (the mine person heading the 

investigating team on the accident); show the date the 

investigation was started; and describe briefly the steps taken to 

prevent a recurrence of such an accident.

Section C- COMPLETE FOR EACH REPORTABLE ACCIDENT,

INJURY, OR ILLNESS

Section C must be completed on each form submitted to MSHA.

Item 5. If you are reporting an occurrence at a surface mine or

other surface activity, circle the code which best describes the accident location in (a). Surface Location; do not mark any codes in (b)

or (c). If you are reporting an occurrence in an underground mine,

circle the code which best describes the underground location in (b)

Underground Location and in (c) Underground Mining Method.

Items 6, 7, and 8. Show the date and time of the occurrence and

the time the shift started in (indicate AM/PM) which the accident/

incident occurred or was observed. 

Item 9. Describe fully the conditions contributing to the occurrence. Detailed descriptions of the conditions provide the basis

for accident and injury analyses which are intended to assist the

mining industry in preventing future occurrences. Please see Part

50 for detail on what your narrative should include.

Item 10. If equipment was involved in the occurrence, name the

type of equipment, the manufacturer, and the model number of

the equipment.

Item 11. If there was a witness to the occurrence, give the name

of the witness.

Item 12. If the occurrence resulted in one or more injuries, report the

number. A separate report must be made on each injured person.

Item 13. Show the name of the injured person. [Note: In these

instructions, "injured person" means a person either injured or ill.]

Item 14. Indicate the sex of the injured person. 

Item 15. Show the date of birth of the injured person. 

Item 16. Show the last four digits of the injured person's Social

Security Number.

Item 17. Give the regular job title of the injured person at the

time he was injured.

Item 18. Check this box if the injury or illness resulted in death.

Item 19. Check this box if the injury or illness resulted in a permanent disability. A permanent disability is any injury or occupational illness other than death which results in the loss (or complete loss of use) of any member (or part of a member) of the

body, or a permanent impairment of functions of the body, or

which permanently and totally incapacitates the injured person

from following any gainful occupation.

MINE ACCIDENT, INJURY, AND ILLNESS REPORT

MSHA FORM 7000-1

41
Item 20. Name the object or substance that directly caused the

injury or illness.

Item 21. Report the nature of injury or illness by naming the illness; or for injuries, by using common medical terms such as

puncture wound, third degree burn, fracture, etc. For multiple

injuries, enter the injury which was the most serious. Avoid general terms such as hurt, sore, sick, etc. 

Item 22. Name the part of body with the most serious injury.

Item 23. Occupational Illness: Circle the code from the list below 

which most accurately describes the illness. These are typical 

examples and are not to be considered the complete listing of the 

types of illnesses and disorders that should be included under 

each category.

Code 21 - Occupational Skin Diseases or Disorders. 

Examples: Contact dermatitis, eczema, or rash caused by 

primary irritants and sensitizers or poisonous plants; oil 

acne; chrome ulcers; chemical burns or inflammations; etc.

Code 22 - Dust Diseases of the Lungs (Pneumoconioses). 

Examples: Silicosis, asbestosis, coal worker’s pneumoconiosis and other pneumoconioses.

Code 23 - Respiratory Conditions Due to Toxic Agents. 

Examples: Pneumonitis, pharyngitis, rhinitis, or acute 

congestion due to chemicals, dusts, gases, or fumes; etc.

Code 24 - Poisoning (Systemic Effects of Toxic Materials). 

Examples: Poisoning by lead, mercury, cadmium, arsenic, or other metals, poisoning by carbon monoxide, hydrogen sulfide, or other gases; poisoning by benzol, carbon tetrachloride, or other organic solvents; poisoning 

by insecticide sprays such as parathion, lead arsenate; 

poisoning by other chemicals such as formaldehyde, 

plastics, and resins; etc.

Code 25 - Disorders Due to Physical Agents (Other than 

Toxic Materials). Examples: Heatstroke, sunstroke, 

heat exhaustion and other effects of environmental heat; 

freezing, frostbite and effects of exposure to low temperatures; caisson disease; effects of ionizing radiation, 

(non-medical non-therapeutic x-rays, radium); effects of 

nonionizing radiation (welding flash, ultraviolet rays, 

microwaves, sunburn); etc.

Code 26 - Disorders Associated with Repeated Trauma.

Examples: Noise-induced hearing loss; synovitis, tenosynovitis, and bursitis; Raynaud's phenomena; and other 

conditions due to repeated motion, vibration, or pressure.

Code 29 - All Other Occupational Illnesses. Examples: 

Infectious hepatitis, malignant and benign tumors, all 

forms of cancer, kidney diseases, food poisoning, 

histoplasmosis; etc.

Item 24. Describe what the employee was doing when he or

she became injured or ill.

Items 25, 26, and 27. Show the number of weeks (or years and

weeks) of experience of the injured person at the job title (indicated

in Item 17), at your operation, and his/her total mining experience.

Section D - RETURN TO DUTY INFORMATION

Section D is to be completed in full when all return-to-duty information is available. If the information is not available within ten

working days after a reportable occurrence, then the first two

pages are sent to MSHA without Section D being completed;

PAGE 3 is then mailed to OIEI- with full information when the

data is available. Until all the items are answered and the

report is sent to OIEI, the occurrence remains an open case.

Item 28. If the injured person was transferred or terminated as a

result of the injury or illness, check the box and answer items 29,

30, and 31. 

Item 29. Show the date that the injured person returned to his/

her regular job at full capacity or was transferred or terminated. 

This date should indicate when the count of days away from 

work and/or days of restricted work activity have stopped.

Item 30. Show the number of workdays 1/ the injured person did

not report to his/her place of employment, i.e., number of days 

away from work.

Item 31. Show the number of workdays the injured person was

on restricted work activity; do not include days away from work

reported in Item 30.

At the bottom of the form, show the name of the person who

completed the form; the date the report was prepared; and the

telephone number where the person who completed the form

may be reached.

1/ Note: The number of lost workdays should not include the day

of injury or onset of illness, or any days on which the employee

was not previously scheduled to work even though able to work,

such as holidays or plant closures

Diagnosis of an "occupational illness or 

disease" under Part 50 does not 

automatically mean a disability or 

impairment for which the miner is 

eligible for compensation, nor does the 

Agency intend for an operator's 

compliance with Part 50 to be equated 

with an admission of liability for the 

reported illness or disease. If a chest xray for a miner with a history of 

exposure to silica or other 

pneumoconiosis causing dusts is rated at 

1/0 or above, utilizing the International 

Labor Office (ILO) classification system, 

it is MSHA's policy that such a finding is, 

for Part 50 reporting, a diagnosis of an 

occuaptional illness, in the nature of 

silicosis or other pneumoconiosis and, 

consequently, reportable to MSHA.

42
(1 ) "Coal or other mine" means (a) an area of land from which

minerals are extracted in nonliquid form or, if in liquid form, are

extracted with workers underground, (b) private ways and roads

appurtenant to such area, and (c) lands, excavations, underground passageways, shafts, slopes, tunnels and workings,

structures, facilities, equipment, machines, tools, or other property including impoundments, retention dams, and tailings ponds,

on the surface or underground, used in, or to be used in, or

resulting from, the work of extracting such minerals from their

natural deposits in nonliquid form, or if in liquid form, with workers

underground, or used in, or to be used in, the milling of such minerals, or the work of preparing coal or other minerals, and

includes custom coal preparation facilities. In making a determination of what constitutes mineral milling for purposes of this Act,

the Secretary shall give due consideration to the convenience of

administration resulting from the delegation to one Assistant

Secretary of all authority with respect to the health and safety of

miners employed at one physical establishment.

(2) "Operator" means any owner, lessee, or other person

who operates, controls, or supervises a coal or other mine or any

designated independent contractor performing services or construction at such mine.

(3) "Occupational injury" means any injury to a worker

which occurs at a mine for which medical treatment is administered, or which results in death, loss of consciousness, inability to

perform ail job duties on any day after an injury, or transfer to

another job.

(4) "Occupational illness" means an illness or disease of a

worker which may have resulted from work at a mine or for 

which an award of compensation is made.

(5) "Medical treatment" means treatment, other than first

aid, administered by a physician or by a registered medical professional acting under the orders of a physician.

DIFFERENCES BETWEEN 

MEDICAL TREATMENT AND FIRST AID

Medical treatment includes, but is not limited to, the suturing of

any wound, treatment of fractures, application of a cast or other

professional means of immobilizing an injured part of the body,

treatment of infection arising out of an injury, treatment of bruise

by the drainage of blood, surgical removal of dead or damaged

skin (debridement), amputation or permanent loss of use of any

part of the body, treatment of second and third degree burns.

Procedures which are diagnostic in nature are not considered by

themselves to constitute medical treatment. Visits to a physician,

physical examinations, x-ray examinations, and hospitalization 

for observations, where no evidence of injury or illness is found 

and no medical treatment given, do not in themselves con-stitute 

medical treatment. However, if scheduled workdays are lost 

because of hospitalization, the case must be reported.

Procedures which are preventative in nature also are not considered by themselves to constitute medical treatment. Tetanus and

flu shots are considered preventative in nature. First aid includes

any one-time treatment and follow-up visit for the purpose of

observation of minor scratches, cuts, burns, splinters, etc.

Ointments, salves, antiseptics, and dressings to minor injuries

are considered to be first aid.

(1) Abrasions

(i) First aid treatment is limited to cleaning a wound, soaking,

applying antiseptic and nonprescription medication, and bandages on the first visit and follow-up visits limited to observation

including changing dressing and bandages. Additional cleaning

and application of antiseptic constitutes first aid where it is

required by work duties that soil the bandage. 

(ii) Medical treatment includes examination for removal of

imbedded foreign material, multiple soakings, whirlpool treatment,

treatment of infection, or other professional treatments and any

treatment involving more than a minor spot-type injury. Treatment

of abrasions occurring to greater than full skin depth is considered medical treatment.

(2) Bruises

(i) First aid treatment is limited to a single soaking or application of cold compresses, and follow-up visits if they are limited

only to observation. 

(ii) Medical treatment includes multiple soakings, draining of

collected blood, or other treatment beyond observation.

(3) Burns, Thermal and Chemical (resulting in destruction of

tissue by direct contact).

(i) First aid treatment is limited to cleaning or flushing the surface, soaking, applying cold compresses, antiseptics or nonprescription medications, and bandaging on the first visit, and followup visits restricted to observation, changing bandages, or additional cleaning. Most first degree burns are amenable to first aid

treatment. 

(ii) Medical treatment includes a series of treatments including

soaks, whirlpool, skin grafts, and surgical debridement (cutting

away dead skin). Most second and third degree burns require

medical treatment. 

(4) Cuts and Lacerations

(i) First aid treatment is the same as for abrasions except the

application of butterfly closures for cosmetic purposes only can

be considered first aid. 

(ii) Medical treatment includes the application of butterfly closures for noncosmetic purposes, sutures (stitches), surgical

debridement, treatment of infection, or other professional treatment.

(5) Eye Injuries

(i) First aid treatment is limited to irrigation, removal of foreign

material not imbedded in eye, and application of nonprescription

medications. A precautionary visit (special examination) to a

physician is considered as first aid if treatment is limited to above

items, and follow-up visits if they are limited to observation only. 

(ii) Medical treatment cases involve removal of imbedded foreign objects, use of prescription medications, or other professional treatment. 

(6) Inhalation of Toxic or Corrosive Gases

(i) First aid treatment is limited to removal of the worker to

fresh air or the one-time administration of oxygen for several minutes. 

(ii) Medical treatment consists of any professional treatment

beyond that mentioned under first aid and all cases involving loss

of consciousness.

(7) Splinters and Puncture Wounds

(i) First aid treatment is limited to cleaning the wound, removal

of foreign object(s) by tweezers or other simple techniques, application of antiseptics and nonprescription medications, and bandaging on the first visit. Follow-up visits are limited to observation

including changing of bandages. Additional cleaning and applications of antiseptic constitute first aid where it is required by work

duties that soil the bandage. 

(ii) Medical treatment consists of removal of foreign object(s)

by physician due to depth of imbedment, size or shape of

object(s), or location of wound. Treatment for infection, treatment

of a reaction to tetanus booster, or other professional treatment,

is considered medical treatment. 

(8) Sprains and Strains

(i) First aid treatment is limited to soaking, application of cold

compresses, and use of elastic bandages on the first visit.

Follow-up visits for observation, including re-applying bandage,

are first aid. 

(ii) Medical treatment includes a series of hot and cold soaks,

use of whirlpools, diathermy treatment, or other professional

treatment.

DEFINITIONS

43
PRIVACY ACT NOTICE FOR 

MINE ACCIDENT, INJURY AND ILLNESS REPORTS

GENERAL

This notice is given as required by Public Law 93-579 (Privacy Act of 1974) December 31, 1974, to the operators of 

mines providing personal information on injury and illness reports and accident investigations. 

AUTHORITY

The authority to collect this information is Section 103 of Public Law 91-173, as amended by Public Law 95-164.

PURPOSE AND USE OF INFORMATION

The information collected will be used to help determine the cause of accidents, injuries, illnesses, and fatalities 

associated with metal and nonmetallic and coal mining. The information will also be used with the intent to 

prevent and reduce future accidents, injuries, fatalities, and illnesses. MSHA provides a copy of a mine operator's 

or contractor's submitted form to the mine operator or contractor who submitted the form.

EFFECTS OF NON-DISCLOSURE

You are required to furnish the information. Without it, MSHA may not be able to help prevent miners and other workers 

from becoming similarly hurt or ill in the future. 

INFORMATION REGARDING PERSONAL IDENTIFICATION

UNDER PUBLIC LAW 93-579 SECTION 7(b)

MSHA asks for the last 4 digits of the social security number under authority of Section 103 of Public Law 91-173, as 

amended by Public Law 95-164. This personal identification helps MSHA establish the accuracy and usefulness of 

the information from injury and illness records. 

BURDEN STATEMENT

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including 

the time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and 

completing and reviewing the collection of information. Records are retained at the mine office closest to the mine 

for 5 years. This is a mandatory collection of information as required by 30 CFR 50.20. The information is used to 

establish injury, accident or illness files used to measure the levels of injury experience and identify those areas 

most in need of improvement. Send comments regarding this burden estimate or any other aspect of this collection 

of information, including suggestions for reducing this burden, the Office of Program Evaluation and Information 

Resources, Mine Safety and Health Administration, U.S. Department of Labor, 201 12th Street South, Arlington, VA 

22202, and to the Office of Management and Budget, Paperwork Reduction Project (1219-0007), Washington, DC 

20503.

Persons are not required to respond to this collection of information unless it displays a currently valid control number.

44
QUARTERLY EMPLOYMENT REPORTS

30 CFR § 50.30 Preparation and submission of MSHA Form 7000-2--Quarterly 

Employment and Coal Production Report.

(a) Each operator of a mine in which an individual worked during any day of a calendar quarter

shall complete a MSHA Form 7000-2 in accordance with the instructions and criteria in

50.30-1 and submit the original to the MSHA Office of Injury and Employment

Information, P.O. Box 25367, Denver Federal Center, Denver, Colo. 80225, within 15 days

after the end of each calendar quarter. These forms may be obtained from the MSHA District

Office. Each operator shall retain an operator's copy at the mine office nearest the mine for 5

years after the submission date.

(b) Each operator of a coal mine in which an individual worked during any day of a calendar

quarter shall report coal production on Form 7000-2.

You may also submit reports by facsimile, 888-231-5515. For assistance in electronic filing,

contact the MSHA help desk at 877-778- 6055. 

Link to File 7000-2 Online

45
Year

MSHA ID #

January February March

Man 

Hours

Number of 

Employees

Man 

Hours

Number of 

Employees

Man 

Hours

Number of 

Employees

1 1 1 

2 2 2 

3 3 3 

4 4 4 

5 5 5 

6 6 6 

7 7 7 

8 8 8 

9 9 9 

10 10 10

11 11 11

12 12 12

13 13 13

14 14 14

15 15 15

16 16 16

17 17 17

18 18 18

19 19 19

20 20 20

21 21 21

22 22 22

23 23 23

24 24 24

25 25 25

26 26 26

27 27 27

28 28 28

29 29 29

30 30 30

31 31 31

Total Average Total Average Total Average

Total Man Hours ____________

46

Average No. Employees ________________
 April May June

Man 

Hours

Number of 

Employees

Man 

Hours

Number of 

Employees

Man 

Hours

Number of 

Employees

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

6 6 6

7 7 7

8 8 8

9 9 9

10 10 10

11 11 11

12 12 12

13 13 13

14 14 14

15 15 15

16 16 16

17 17 17

18 18 18

19 19 19

20 20 20

21 21 21

22 22 22

23 23 23

24 24 24

25 25 25

26 26 26

27 27 27

28 28 28

29 29 29

30 30 30

31 31 31

Total Average Total Average Total Average

Total Man Hours ____________

Average No. Employees ________________

47
 July August September

Man 

Hours

Number of 

Employees

Man 

Hours

Number of 

Employees

Man 

Hours

Number of 

Employees

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

6 6 6

7 7 7

8 8 8

9 9 9

10 10 10

11 11 11

12 12 12

13 13 13

14 14 14

15 15 15

16 16 16

17 17 17

18 18 18

19 19 19

20 20 20

21 21 21

22 22 22

23 23 23

24 24 24

25 25 25

26 26 26

27 27 27

28 28 28

29 29 29

30 30 30

31 31 31

Total Average Total Average Total Average

Total Man Hours ____________

Average No. Employees ________________

48
 October November December

Man 

Hours

Number of 

Employees

Man 

Hours

Number of 

Employees

Man 

Hours

Number of 

Employees

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

6 6 6

7 7 7

8 8 8

9 9 9

10 10 10

11 11 11

12 12 12

13 13 13

14 14 14

15 15 15

16 16 16

17 17 17

18 18 18

19 19 19

20 20 20

21 21 21

22 22 22

23 23 23

24 24 24

25 25 25

26 26 26

27 27 27

28 28 28

29 29 29

30 30 30

31 31 31

Total Average Total Average Total Average

Total Man Hours ____________

Average No. Employees ________________

49
Quarterly Mine Employment

and Coal Production Report

DOL - MSHA - PEIR - OIEIP.O. Box 25367Denver, Colorado 80225 - 0367

Check here if this report is being submi

If any information below is incorrect, pl

County

Operation Na

Operation Name:Operating Company Name and Mailing 

Operating Company Name an

County:

Copy 1 - Return to MS

MSHA ID Number

MSHA Form 7000-2, July 97, (revised)

1. Persons Working, Employee-Hours, and Coal Production

Operation Sub Unit Code(s)

prevlously reported:

(1)

01

Code (2)Average number

of persons working

during quarter

(3) Total employee

hours worked

during the quarter

(4) Production of clean coal

during quarter, (short

tons)

02

03040506

1217

3099

UndergroundMineSurfaceMine(includingassociatedshops andyards)

2. Other Reportable Data

How many MSHA reportable injuries or illnesses did you have this quarter?

Person to be contactedregarding this report:

Name

Title Tel. No. ( ) - area code

Underground

Surface Shops,Yards, etc.Strip, Open Pit,or Quarry

Auger (Coal Mine Only)

Culm Bank or Refuse

Pile (Coal Mine Only)

Dredge

Other Surface Mining(Metal/Nonmetal Only)

Independent Shops or YardsMill Operations, Preparation Plants, orBreakers(include associated shops and yards)Office (professional and clericalemployees at the mine or plant workingin an office)

OMB Number 1219-0007; Approval Expires July 31, 2014

For Quarter Year

(SEE INSTRUCTIONS ON REVERSE SIDE OF COPY 2)
 Quarterly Mine Employment U.S. Department of Labor

 and Coal Production Report Mine Safety and Health Administration

 OBM Control Number 1219-0007; Approval Expires July 31, 2011

 This report is required by law (30 U.S.C. subsection 813; 30 C.F.R. Part 50). Failure to report may result in the issuance of a

citation or order under 30 U.S.C. subsection 814 to an operator of a coal or other mine, the assessment of a civil penalty

against an operator of a coal or other mine under 30 U.S.C. subsection 820(a), and the institution of a civil action under 30 U.S.

C. subsection 818. An individual who knowingly makes a false statement in any report shall, upon conviction, be punished by a

fine of not more than $10,000 or by imprisonment for not more than 5 years, or both, under 30 U.S.C. subsection 820(f).

Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies,

conceals or covers up by any trick scheme, or device, a material fact, or makes or uses any false writing or document knowing

the same to contain any false, fictitous or fraudulent statement or entry, shall be fined under 18 U. S. C. or imprisioned not

more than five years, or both, under 18 U. S. C. subsection 1001.

 Important: (INSTRUCTIONS)

This form must be completed and mailed or faxed within 15 days after the end of each calendar quarter.

1. Fill out this form as completely as possible and return Copy 1 of this report to:

MSHA

 PEIR - Office of Injury and Employment Information OR You may FAX Copy 1 to Fax # 1- 888 - 231 - 5515

 P.O. BOX 25367

 Denver, CO 80225-0367 

2. If it is necessary to make any address changes, indicate correct information on this form.

3. When pre-addressed, this form is only for the operation with I. D. number as shown. Do not use for any other

operation.

4. Sand and Gravel operators report employment data under code 03 or 06 as appropriate, except for data on office

workers which should be reported under code 99.

5. All mine operators and independent contractors reporting as required by 30 C.F.R. Part 50, should show persons

working and employee hours worked; those producing coal should also show production date.

6. Independent Contractors should complete quarterly only one form for activities at all coal locations, and one

form for activities at metal and nonmetal locations.

The public reporting burden for this collection of Information is estimated to average 30 minutes per response, including the time for reviewing

 instructions, searching existing date sources, gathering and maintaining the date needed, and completing and reviewing the collection of Information. 

 Send comments regarding this estimated response time or any other aspect of this collection of information, including suggestions for reducing this 

 burden, to Mine Safety and Health Administration, U.S. Department of Labor, 1100 Wilson Boulevard, Arlington, VA 22209-3939.

 Persons are not required to respond to this collection of information unless this form displays a currently valid OMB control number.

 MSHA Form 7000-2, July 97 (revised)

51
Link to Part 56 Regulations 

52

Part 56
30 CFR Parts 1 to 199 

The Government Printing Office (GPO) processes all sales and distribution of the CFR. 

For payment by credit card, call 202.512.1800, M – F, 8 a.m. to 4 p.m. e.s.t. or fax your 

order to 202.512.2250, 24 hours a day. For payment by check, write to the 

Superintendent of Documents, Attn: New Orders, P. O. Box 371954, Pittsburgh, PA 

15250 – 7954. For GPO Customer Service call 202.512.1803. 

Mine Safety Associates Order Form 

PO Box 872, Price, Utah 84501 Qty Price Extension 

30 CFR Part 40-50, 100 & 104 (Purple & White) x$12

30 CFR Part 47, 56/57/58 & 62 (Blue & White) x$12

30 CFR Part 46/47/48, 56/57/58 & 62 (Green & White) x$15

30 CFR Part 75 (Gray & White) x$15

30 CFR Part 77 (Yellow & White) x$10

30 CFR Part 47, 48, 62 & 77 (Black & White) x$12

30 CFR Part 46 & 48 (Yellow) x$3

1977 Act (Pub. Law 95 – 164) (Brown & White) x$6

Quantity Discounts

Books* Disc.

2-9-----------------25%

10-24--------------33%

25-49--------------42%

50+----------------50%

Total books* ___________ Subtotal _____________

(See table at left) Disc% _____________

(Subtotal x Disc%) Disc $ _____________

 (Subtract Disc $ from Subtotal) Total _____________

 Add 6.25% sales tax in Utah only ______________

Check # ________enclosed

Use PO# ______________

Phone: 800.430.2377 Fax: 435.637.8614

53
30 CFR § 56.1000 Notification of commencement of operations and closing of mines. 

The owner, operator, or person in charge of any metal and nonmetal mine shall notify the 

nearest Mine Safety and Health Administration and Metal and Nonmetal Mine Safety and 

Health District Office before starting operations, of the approximate or actual date mine 

operation will commence. The notification shall include the mine name, location, the 

company name, mailing address, person in charge, and whether operations will be 

continuous or intermittent. 

When any mine is closed, the person in charge shall notify the nearest district office as 

provided above and indicate whether the closure is temporary or permanent. 

Link to Commencement/Closure Notice

54
56.1000 Notification of commencement of operations and closing of mines. 

Please check all appropriate boxes and supply required information: 

On or about __________________________, 20_______, we shall:

Commence (start operation) and:

Operation will be continuous Operation will be intermittent

Operations are estimated to continue for ______________ days months. 

Operation will seasonally close.

Process operations will close but maintenance/loadout will continue.

Operation will permanently close (cease all operations permanently).

Portable Plants: Move to a new location 

(Moving from) ____________________________________________________ 

(City) (County) (State) 

(Moving to) ____________________________________________________ 

(City) (County) (State) 

The mining operations are located at (provide directions, with mileage, from the nearest city or 

town by highway or county/local road): 

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________ 

______________________________________________________________________________ 

County where operation is located: __________________________ 

Company Name: ________________________________________________________ 

Mine Name: ____________________________________________________________ 

Office Address: __________________________________________________________ 

Mine MSHA ID No.: __-__________ Contact Phone No.: _____-______-______

Person in Charge: ________________________________________ 

PLEASE MAIL, EMAIL OR FAX THE ABOVE INFORMATION TO THE LOCAL 

MSHA FIELD OFFICE: 

See the following web site for Field Office contact information: 

Contact Us

55
(Field Office info is found at the bottom of the web page – select the appropriate MSHA District Office) 

56.1000 Notification of commencement of operations and closing of mines. 

The owner, operator, or person in charge of any metal and nonmetal mine shall notify the nearest Mine Safety and 

Health Administration and Metal and Nonmetal Mine Safety and Health District Office before starting operations, of 

the approximate or actual date mine operation will commence. The notification shall include the mine name, location, 

the company name, mailing address, person in charge, and whether operations will be continuous or intermittent. 

When any mine is closed, the person in charge shall notify the nearest district office as provided above and indicate 

whether the closure is temporary or permanent.

56
FIRE FIGHTING EQUIPMENT INSPECTION

30 CFR § 56.4201 Inspection. 

(a) Firefighting equipment shall be inspected according to the following schedules:

(1) Fire extinguishers shall be inspected visually at least once a month to determine that they

are fully charged and operable.

(2) At least once every twelve months, maintenance checks shall be made of mechanical

parts, the amount and condition of extinguishing agent and expellant, and the condition of

the hose, nozzle, and vessel to determine that the fire extinguishers will operate

effectively.

(3) Fire extinguishers shall be hydrostatically tested according to Table C-1 or a schedule

based on the manufacturer's specifications to determine the integrity of extinguishing

agent vessels.

(4) Water pipes, valves, outlets, hydrants, and hoses that are part of the mine's firefighting

system shall be visually inspected at least once every three months for damage or

deterioration and use-tested at least once every twelve months to determine that they

remain functional.

(5) Fire suppression systems shall be inspected at least once every twelve months. An

inspection schedule based on the manufacturer's specifications or the equivalent shall be

established for individual components of a system and followed to determine that the

system remains functional. Surface fire suppression systems are exempt from these

inspection requirements if the systems are used solely for the protection of property and

no persons would be affected by a fire.

(b) At the completion of each inspection or test required by this standard, the person making the

inspection or test shall certify that the inspection or test has been made and the date on which

it was made. Certifications of hydrostatic testing shall be retained until the fire extinguisher

is retested or permanently removed from service. Other certifications shall be retained for

one year.

57
Table C-1 Hydrostatic Test Intervals for Fire Extinguishers 

Extinguisher type 

Test 

interval

(years)

Soda Acid

Cartridge-Operated Water and/or Antifreeze

Stored-Pressure Water and/or Antifreeze

Wetting Agent 

Foam

AFFF (Aqueous Film Forming Foam) 

Loaded Stream

Dry-Chemical with Stainless Steel Shells

Carbon Dioxide 

Dry-Chemical, Stored Pressure, with Mild Steel Shells, 

Brazed Brass Shells, or Aluminum Shells 

Dry-Chemical, Cartridge or Cylinder 

Operated, with Mild Steel Shells

Bromotrifluoromethane Halon 1301 

Bromochlorodifluoromethane Halon 1211 

Dry-Powder, Cartridge or Cylinder-Operated, with Mild 

Steel Shells1

5

5

5

5

5

5

5

5

5

12 

12 

12 

12 

12 

1

Except for stainless steel and steel used for compressed gas cylinders, all other steel shells are 

defined as "mild steel" shells.

30 CFR § 56.4203 Extinguisher recharging or replacement.

Fire extinguishers shall be recharged or replaced with a fully charged extinguisher promptly after 

any discharge. 

58
56.4201 Monthly Fire Extinguisher Check 

Location

Day Initial Day Initial Day Initial Day Initial Day Initial Day Initial Day Initial Day Initial Day Initial Day Initial Day Initial Day Initial

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

59
EVACUATION PLAN 

30 CFR § 56.4330 Firefighting, evacuation, and rescue procedures. 

(a) Mine operators shall establish emergency firefighting, evacuation, and rescue procedures.

These procedures shall be coordinated in advance with available firefighting organizations.

(b) Fire alarm procedures or systems shall be established to promptly warn every person who

could be endangered by a fire.

(c) Fire alarm systems shall be maintained in operable condition.

60
REPORTING A MINE EMERGENCY 

IN THE EVENT OF

A MINE EMERGENCY

OR

AN ACCIDENT REQUIRING IMMEDIATE NOTIFICATION 

Call 1-800-746-1553

Operator Name

Federal Mine ID Phone Number

MSHA Field Office

District Office

Directions to the mine

Emergency Evac. Area

State Department of Mines Phone Number

OTHER EMERGENCY PHONE NUMBERS 

Emergency Medical Service 911

Fire Department 911

State Highway Patrol 911

County Sheriff 911

Ambulance 911

Hospital 911

Life Flight 911

Poison Control Center 1-800-222-1222

Latitude

Longitude

61
EXPOSURE MONITORING 

30 CFR § 56.5002 Exposure monitoring. 

Dust, gas, mist, and fume surveys shall be conducted as frequently as necessary to determine the 

adequacy of control measures. 

Program Policy Manual 

The standard requires mine operators to conduct dust, gas, mist and fume surveys as frequently 

as necessary to determine the adequacy of control measures. The purpose is to help assure that 

the miners are not exposed to harmful concentrations of airborne contaminants. This could 

include carbon monoxide in underground mines, nitrogen oxides after blasting, welding fumes, 

silica- containing dust, mercury and any other airborne contaminant, especially where there is a 

history of overexposures. It does not include noise. 

There are many methods used to measure airborne contaminants. The sampling and analytical 

methods used by the mine operator should be consistent with established scientific principles, 

such as NIOSH recommended methods and comparable to the 1973 ACGIH TLVs. 

62
30 CFR 56 / 5002 

Exposure Monitoring for Metal/Non-Metal Small Mines 

Mine/Contractor ID #___________Mine Name________________Date______ 

Operator should review their MSDS sheets for hazardous contaminants or obtain a 

laboratory analysis of their ore body to determine health hazards associated with their raw 

materials. The state or customers may already have such an analysis if the small operator 

does not have one. 

Dust Hazards Determined Yes No N/A

Fibers

Silica

Arsenic

Lead

Nuisance Particulate

Other

Hazard Sources should be 

identified and surveyed to make sure 

the hazards are controlled or 

eliminated.

Crushing

Screening

Conveying

Hauling

Dumping

Transfer Points

Drilling

Blasting

Roadways

Stockpiles

Workstations

Mobile Equipment

Fumes Hazard Determined Do a complete 

evaluation of all welding operations 

to include MSDS sheets. Hazard 

Sources should be identified and

surveyed to make sure the hazards 

are controlled or eliminated.

Yes No N/A

Hard Surfacing

Mild Steel

Aluminum

Other

63
Hazard Sources 

Confined Space

Closed Shop Location

Loader Buckets

Truck Beds

Gases Hazard Determined Do a complete 

evaluation of all Mobile Equipment 

exhaust system and any internal

combustion engines running in 

confined areas.

Yes No N/A

Loaders

Haul Trucks

Shop Trucks

Pickup Trucks

Gas Powered Air Compressors

Chemical Storage Areas

Other

Hazard Sources 

Surge Tunnels

Shops

Storage Trailers

Sump Pump Internal Combustion

Mists Hazard Determined Do a complete 

evaluation for hazards Mists.

Yes No N/A

Oil Leaks Under Pressure

Other

Hazard Sources Mobile Equipment

Mobile Equipment

Fuel Injectors

Other

Yes No N/A

Employee Input and Interviews

Industry and Company Health Trends

Physical/Visual Observation

Workplace Examination

64
56.5002 Exposure Monitoring 

Document this survey on your 56.18002 Workplace Exam 

Dust, gas, mist, and fume surveys shall be conducted as frequently as necessary to determine the 

adequacy of control measures. 

What controls do you have in place to protect miners from being exposed to: 

1. Dust Complete laboratory analysis of ore body to determine health hazards 

associated with raw materials. 

A. Hazards Determined (Le. Fibers, Silica, Arsenic, Lead, Nuisance Particulate,

Other)

B. Hazard Source (Le. Crushing Screening, Conveying, Hauling, Dumping

Transfer Points, Drilling, Blasting, Roadways Stockpiles, Workstations,

Mobile Equipment)

Water roads. Lower speed limits. Part 47

2. Gases Complete evaluation of all Mobile Equipment exhaust system and any

internal combustion engines running in confined areas.

A. Hazard Determination (I.e. Loaders Haul Trucks, Shop Trucks, Pickup

Trucks Gas powered Air compressors, Chemical storage areas, Other)

B. Hazard Sources (i.e. Surge Tunnels, Shops, Storage Trailers, Sump Pump

internal combustion).

Part 47

3. Mists Complete evaluation for hazardous mists.

A. Hazard Determination (i.e. 011 leaks under pressure, Other)

B. Mobile Equipment (i.e. Fuel Injectors, other)

Shut down and repair equipment. Part 47 

4. Fumes Complete evaluation of all welding operations to include MSDS sheets.

A. Hazard determination (Le. Hard Surfacing, Mild Steel, Aluminum, Other)

B. Hazard Source (i.e. Confined Spaces Closed shop Location, Loader Buckets

Truck Beds, Other)

Ventilation, fans as needed. Part 47

65
SUMMARY OF KEY MSHA REQUIREMENTS FOR A 

RESPIRATORY PROTECTION PROGRAM 

30 CFR § 56.5005 Control of exposure to airborne contaminants. 

Control of employee exposure to harmful airborne contaminants shall be, insofar as feasible, by 

prevention of contamination, removal by exhaust ventilation, or by dilution with uncontaminated 

air. However, where accepted, engineering control measures have not been developed or when 

necessary by the nature of work involved (for example, while establishing controls or occasional 

entry into hazardous atmospheres to perform maintenance or investigation), employees may 

work for reasonable periods of time in concentrations of airborne contaminants exceeding 

permissible levels if they are protected by appropriate respiratory protective equipment. 

Whenever respiratory protective equipment is used a program for selection, maintenance, 

training, fitting, supervision, cleaning, and use shall meet the following minimum requirements: 

(a) Respirators approved by NIOSH under 42 CFR part 84 which are applicable and suitable for

the purpose intended shall be furnished and miners shall use the protective equipment in

accordance with training and instruction.

(b) A respirator program consistent with the requirements of ANSI Z88.2-1969, published by the

American National Standards Institute and entitled "American National Standards Practices

for Respiratory Protection ANSI Z88.2-1969," approved August 11, 1969, which is hereby

incorporated by reference and made a part hereof. This publication may be obtained from the

American National Standards Institute, Inc., 1430 Broadway, New York, New York 10018,

or may be examined in any Metal and Nonmetal Mine Safety and Health District Office of

the Mine Safety and Health Administration.

(c) When respiratory protection is used in atmospheres immediately harmful to life, the presence

of at least one other person with backup equipment and rescue capability shall be required in

the event of failure of the respiratory equipment.

ANSI Z88.2 – 1969, requires, in part, that:

(1) Written standard operating procedures be developed governing respirator selection, use and

care (3.5.1, 7.11),

(2) The user receive instruction and training in the nature of the hazard, the proper use of the

respirator, and its limitations (3.5.3, 7.4),

(3) The user be provided an opportunity to wear the respirator in a test atmosphere (7.4) (i.e.

qualitative or quantitative fit test)

(4) Respirators not be worn when conditions prevent a good face seal, such as a growth of beard

or sideburns that project under the face piece (7.5);

(5) Face piece fit be checked by the wearer each time the respirator is worn, by following the

manufacturer’s face piece – fitting instructions, such as conducting a positive and negative

pressure test (7.5);

66
(6) The program adequately address respirator maintenance and care, including inspection for

defects, cleaning and disinfecting, repair, and storage (8); and,

(7) Frequent random inspections be conducted by a qualified individual to assure that respirators

are properly selected, used, cleaned, and maintained (10.3).

1

The numbers in parenthesis refer to the cited section of the ANSI standard. 

Additionally, pursuant to 30 CFR 56/57.20011, areas where respirator use is required, must be 

posted with signs warning of the nature of the hazard and protective action required. 

It is important that the entire ANSI Z88.2 – 1969 be reviewed when establishing or 

evaluating a respiratory protection program. A copy of ANSI Z88.2 – 1969, is available from 

your local MSHA, Metal and Nonmetal Mine Safety and Health office. MSHA personnel are 

also available to assist mine operators in establishing an adequate respiratory protection program. 

Please note, however, that MSHA does not accept respiratory protection in lieu of feasible 

engineering controls.

Additional information on respiratory protection, including a list of NIOSH certified respirators, 

is available from the National Institute for Occupational Safety and Health @ 1.800.35NIOSH.

PROCEDURES FOR CHECKING AND TESTING RESPIRATOR FIT

Negative Pressure Fit Check – used with tight fitting face pieces to check the seal before 

entering a potentially contaminated atmosphere. The inlet(s) on the filters are sealed while the 

wearer gently inhales. The inward collapse of the mask, and absence of a noticeable inward rush 

of air, provides reasonable assurance that the mask is not leaking and is properly seated on the 

face. 

Positive Pressure Fit Check – used with tight fitting face pieces to check the seal before 

entering a potentially contaminated atmosphere. The exhalation port is sealed while the wearer 

gently exhales. The buildup of pressure inside the mask, and absence of a noticeable outward 

rush of air, provides reasonable assurance that the mask is not leaking and is properly seated on 

the face. 

Qualitative Fit Test – a pass/fail fit test that relies on the subject’s sensory response to detect 

the leakage of a challenge agent past the respirator seal. The test is performed by exposing the 

wearer to a challenge agent easily detected by irritation (smoke), taste (Saccharine or Bittrex) or 

odor (isoamyl acetate). The subject must be able to sense the agent when not protected. If irritant 

smoke or isoamyl acetate are used, the respirator must be equipped with an appropriate air –

purifying filter. 

Quantitative Fit Test – a fit test that uses an instrument to measure the effectiveness of a 

respirator seal in excluding the ambient atmosphere. The test is performed by dividing the 

measured concentration of a challenge agent outside of the respirator by the measured 

concentration of the challenge agent inside the respirator face piece. The normal air purifying 

element should be replaced with an essentially perfect purifying element such as an HEPA filter. 

67
 Generic Written Respiratory Protection Program 

Respiratory Protection Program

Operator Name: I.D.# ____

1. Written Procedures

a. Hazard Identification & Respirator Selection – Air purifying respirators are

designed to protect persons from breathing specific airborne contaminants and

often provide little or no protection against other contaminants. Table RPP1 lists

for each hazard, the respirators this company will use, their limitations, and job

duties/areas of use.

b. Program Administrator -- Respiratory protection programs will be administered

by ____________________________, who has sufficient knowledge of the

subject to properly supervise the program.

2. Employee Training

Training time, min ____ to ____ 

Teaching Method________________________________________________________ 

Training Materials _______________________________________________________ 

Evaluation Method _________________________________________________________ 

Training will be done by ____________________________________________________ 

Training will cover all affected employees and supervisors. Training will be conducted before 

the worker begins work in the area where the respirator is needed. Training will include: 

1. Engineering and administrative controls, order of priority of controls, proper use and

maintenance of these controls.

2. Reason respirators are required -- explanation of the hazard and its effects (i.e. acute or

chronic)

3. Selection of a respirator -- fit, comfort, one you can breath through.

4. Health conditions that interfere with respirator use

5. How long can you wear a respiratory device, how to detect breakthrough, excessive

resistance to flow etc.

6. Types of respirators and limitations of each including N,R, and P and 95, 99 and 100.

7. Respirators used at particular site and proper procedures for mounting, care and maintenance

of each.

8. Proper fit

a. No facial hair

b. Medical conditions affecting skin texture

c. Self-fit test

d. Professional fit tests

9. Inspection, cleaning/disinfecting and storage – including reusable and throwaways.

68
Table RPP-1. Respirators Used on Mine Site

Hazard Respirator 

Manufacturer

Model No. Respirator Limitations Job Duties/Location Where Protection Will Be Used

69
3. Fit-testing

1. All persons required to use a respirator will be fit tested first.

2. Annual fit testing to be conducted on (date)_____ by (person/organization

conducting

test)____________________________________________________________.

3. The test will be conducted by subjecting each person, while wearing the appropriate

respirator, to the following fit test procedure:

___Qualitative Fit Test by one of the following methods:

a. Stannic Chloride Smoke____

b. Bitrex ____

c. Saccharin____

____Quantitative Fit Test - the fit is acceptable if the person, while wearing a fitted 

respirator which has been outfitted with a sample port, is subjected to a test 

atmosphere (usually mineral oil mist) and the concentration of test atmosphere 

inside the respirator is negligible. 

4. The person will perform exercises while wearing the respirator in the test atmosphere

to determine if the respirator fits. Exercises will simulate at least the work of lifting,

bending over, talking, movement of the head in all directions and exhibiting various

facial expressions.

5. A written record form of the following will be maintained for these employees. (See

copy of record form at end of this RPP):

a. Name of employee tested;

b. Date of testing;

c. Respirator manufacturer, model, style, and size worn;

d. Fit-test protocol and the name of the person administering the test;

e. Fit-test results.

6. If during respiratory fit testing, the employee experiences difficulty breathing

through the respirator(s), the employee will be evaluated by a physician to determine

his/her medical suitability for wearing a respirator.

70
4. Respirator cleaning and disinfecting

Users will be trained: 

1. To inspect respirators prior to each use to determine that they are functioning

properly

2. To clean and disinfect or replace the respirator on a regular basis according to

manufacturer's recommendations, or after each use if they are used by more than

one person. Adequate cleaning and disinfecting facilities will be provided at the

following convenient

location______________________________________________________

3. To store respirators in the following convenient, clean and sanitary location

______________________________________________________________

4. For reusable respirators (person) ______________________________ will be

trained to be knowledgeable in the respirator manufacturer recommendations for

the use, care and maintenance of each model of respirator provided by the

Company

5. Employees will be instructed as to where and how to obtain new disposable

respirators or respirator cartridges when theirs become unusable, unsanitary, or

exhibit excessive breathing resistance or breakthrough. These respirators will be

available at the following locations:

__________________________________________________________________

_.

-

__________________________________________________________________

_

5. Records of actions taken

(See fit testing/training record form at end of this RPP) 

1. Records of fit-test which identify:

a. The exact model and size respirator

b. Date of testing

c. The fit-test method and

d. Whether the person passed or failed the test.

71
2. Records of training provided which include at least: 

 a. Identification of persons 

 b. Date of training and 

 c. Topics covered. 

6. A statement of use 

1. Assigned respirators will be worn by persons at all times while in the normal 

work areas where persons may be overexposed; These areas will be posted 

“Respirator Required” and

2. Work area(s) affected will be periodically checked to ensure that employees are 

using respirators and to check dust controls, employee exposure, and employee 

stress due to breathing resistance or heat. The area supervisor will include this 

check on his/her daily walk-around inspection.

72
Respirator Fit Testing Record

This is to certify that ________________________________, has been 

trained and fitted in the use, limitations, and maintenance of the following 

respirator: 

Manufacturer__________ 

Model number__________ 

Protection against _____________________ 

using the following protocol. 

Bitrex Solution Aerosol ____ 

Saccharin Solution Aerosol ____ 

Stannic Chloride Smoke ____ 

The following test exercises were performed while being tested for at least 

60 seconds each. 

1. Normal breathing

2. Breathing deeply

3. Turning head from side to side, inhaling in each position

4. Nodding head up and down, inhaling in the up position

5. Counting or reading the rainbow passage

“ I acknowledge that I have received respirator training and have been fit test 

according to the above instructions. By my signature, I verify: 

____Saccharin or Bitrex Protocol -- That I did not detect the test solution 

during any of the actions required in fit testing me with the respirator on 

which this test qualifies me for. I did, however, taste the test solution 

during the sensitivity test”.

____Stannic Chloride Protocol – That I did not smell the stannic chloride 

smoke with the respirator on and (or) did not need to cough because of 

it”. I did smell the smoke when tested for sensitivity with the respirator 

off. 

 Signature of Person Fit Tested Date 

Signature of Tester Date 

73
CONTINUITY AND RESISTANCE 

30 CFR § 56.12028 Testing grounding systems. 

Continuity and resistance of grounding systems shall be tested immediately after installation, 

repair, and modification; and annually thereafter. A record of the resistance measured during the 

most recent tests shall be made available on a request by the Secretary or his duly authorized 

representative. 

Program Policy Manual 

This intent of this standard is to ensure that continuity and resistance tests of grounding systems 

are conducted on a specific schedule. These tests will alert the mine operator if a problem exists 

in the grounding system which may not allow the circuit protective devices to quickly operate 

when faults occur. With the exception of fixed installations, numerous fatalities and injuries have 

occurred due to high resistance or lack of continuity in equipment ground systems. These 

accident could have been prevented by proper testing and maintenance of grounding systems. 

Grounding systems typically include the following:

1. equipment grounding conductors - the conductors used to connect the metal frames or

enclosures of electrical equipment to the grounding electrode conductor;

2. grounding electrode conductor - the conductors connecting the grounding electrode to the

equipment grounding conductor; and

3. grounding electrodes - usually driven rods connected to each other by suitable means, buried

metal, or other effective methods located at the source, to provide a low resistance earth

connection.

Operators shall conduct the following tests: 

1. Equipment grounding conductors - continuity and resistance must be tested immediately

after installation, repair, or modification, and annually if conductors are subjected to

vibration, flexing or corrosive environments;

2. Grounding electrode conductor - continuity and resistance must be tested immediately after

installation, repair, or modification, and annually if conductors are subjected to vibration,

flexing or corrosive environments; and

3. Grounding electrodes - resistance must be tested immediately after installation, repair, or

modification, and annually thereafter.

Conductors in fixed installations, such as rigid conduit, armored cable, raceways, cable trays, 

etc., that are not subjected to vibrations, flexing or corrosive environments may be examined 

annually by visual observation to check for damage in lieu of the annual resistance test. When 

operators elect to conduct this visual examination as a method of compliance with 30 CFR 

74
56/57.12028, MSHA will require that a record be maintained of the most recent annual visual 

examination. 

The grounding conductors in trailing cables, power cables, and cords that supply power to tools 

and portable or mobile equipment must be tested as prescribed in the regulation. This 

requirement does not apply to double insulated tools or circuits protected by ground-fault-circuit 

interrupters that trip a 5 milli-amperes or less. 

Testing of equipment grounding conductors and grounding electrode conductors is not required 

if a fail-safe ground wire monitor is used to continuously monitor the grounding circuit and 

which will cause the circuit protective devices to operate when the grounding conductor 

continuity is broken. 

A record of the most recent resistance tests conducted must be kept and made available to the 

Secretary or his authorized representative upon request. When a record of testing is required by 

the standard, MSHA intends that the test results be recorded in resistance value in ohms. 

75
100

EXAMPLE
56.12028 Grounding System Resistance Test

LOCATION DATE

SEASON TYPE SOIL

SOIL 

CONDITION

DRY

MOIST TEMP

TYPE SYSTEM SINGLE ROD

DEPTH FT

MULTIPLE RODS 

LONGEST DIMENSION FT

BURIED STRIPS OR WIRE

LONGEST DIMENSION FT

DISTANCE TO AUXILARY CURRENT ELECTRODE FT

AUXILIARY POTENTIAL

 ELECTRODE

DISTANCE RESISTANCE

__________FT __________OHMS

__________FT __________OHMS

__________FT __________OHMS

__________FT __________OHMS

__________FT __________OHMS

__________FT __________OHMS

__________FT __________OHMS

__________FT __________OHMS

__________FT __________OHMS

GROUND

__________FT __________OHMS UNDER

TEST

__________FT __________OHMS

XRESISTANCE (OHMS)DISTANCE (FEET)
30 CFR § 57.13015 Inspection of compressed-air receivers and other unfired 

pressure vessels. 

(a) Compressed-air receivers and other unfired pressure vessels shall be inspected by

inspectors holding a valid National Board Commission and in accordance with the

applicable chapters of the National Board Inspection Code, a Manual for Boiler and

Pressure Vessel Inspectors, 1979. This code is incorporated by reference and made a

part of this standard. It may be examined at any Metal and Nonmetal Mine Safety

and Health District Office of the Mine Safety and Health Administration, and may

be obtained from the publisher, the National Board of Boiler and Pressure Vessel

Inspector, 1055 Crupper Avenue, Columbus, Ohio 43229.

(b) Records of inspections shall be kept in accordance with requirements of the National

Board Inspection Code, and the records shall be made available to the Secretary or

his authorized representative.

*Recommendation-Make copies of certifications and insert in binder.

*Note-Certification requirements vary from state to state.

78
30 CFR § 56.13017 Compressor discharge pipes. 

Compressor discharge pipes where carbon build-up may occur shall be cleaned 

periodically as recommended by the manufacturer, but no less frequently than once 

every two years. 

Type of Compressor Location of 

Compressor

Date Inspected Inspected By

All air compressors have to have a full inspection every 2 years. You need to take off the 

pipe from the compressor to the tank, inspect and clean it. This pipe can be HOT, let it 

cool. Make sure the compressor is locked out and tagged out. 

79
MOBILE EQUIPMENT EXAMS

30 CFR § 56.14100 Safety defects; examination, correction and records. 

(a) Self-propelled mobile equipment to be used during a shift shall be inspected by the

equipment operator before being placed in operation on that shift.

(b) Defects on any equipment, machinery, and tools that affect safety shall be corrected in a

timely manner to prevent the creation of a hazard to persons.

(c) When defects make continued operation hazardous to persons, the defective items including

self-propelled mobile equipment shall be taken out of service and placed in a designated area

posted for that purpose, or a tag or other effective method of marking the defective items

shall be used to prohibit further use until the defects are corrected.

(d) Defects on self-propelled mobile equipment affecting safety, which are not corrected

immediately, shall be reported to and recorded by the mine operator. The records shall be

kept at the mine or nearest mine office from the date the defects are recorded, until the

defects are corrected. Such records shall be made available for inspection by an authorized

representative of the Secretary.

Program Policy Manual

This standard applies to all off-road and on-road self-propelled equipment used on mine 

property, including vehicles such as vans, suburbans, and pick-up trucks that are used at mine 

sites and remain on mine property. In most instances, it does not apply to vehicles used to 

transport persons between locations off mine property to mine property; however, if such 

vehicles transport personnel on mine property (e.g., from the gate to various sites at the mine), 

then such equipment must be inspected. 

This standard will not be cited when an audible warning device has been installed on heavy duty 

mobile equipment at surface mines and surface operations of underground mines, but is 

inoperative because of electrical or mechanical defect. 

Standard .14132 shall be used when the equipment has not been equipped with audible warning 

devices, or when they have been so equipped, and the device is not operational for whatever 

reason. 

In some cases, mine operators have installed audible reverse alarms on underground equipment 

because prevailing conditions have dictated the need for a warning device to ensure miner safety. 

In this instance, Standard .14100 can be considered if the alarm is inoperable or inaudible and the 

defect can be shown to affect the safety of workers in the area. Surrounding noise levels, 

confined work areas, and distracting work assignments shall be considered at the time. 

80
"X" ALL ITEMS IN ACEPTABLE CONDITION. IF REPAIRS ARE NEEDED LIST BELOW. CONDITIONS AFFECTING 

SAFE OPERATION MUST REPAIRED BEFORE CONTINUING OPERATION OF THE EQUIPMENT.

EQUIPMENT _____________________________ EQUIPMENT ____________________________________

NUMBER _____________________________ NUMBER ____________________________________

OPERATOR _____________________________ OPERATOR ____________________________________

Date Date

B-Up Alarm B-Up Alarm

Brakes Brakes

Park Brake Park Brake

Fire Ext. Fire Ext.

Horn Horn

Seat Belt Seat Belt

Windows Windows

Mirrors Mirrors

Wipers Wipers

Defroster Defroster

Engine Engine

Fuel Tank Fuel Tank

Heater Heater

Hydraulics Hydraulics

Lights Lights

Steering Steering

Tires Tires

LIST ANY REPAIRS NEEDED: LIST ANY REPAIRS NEEDED:

EQUIPMENT _____________________________ EQUIPMENT ____________________________________

NUMBER _____________________________ NUMBER ____________________________________

OPERATOR _____________________________ OPERATOR ____________________________________

Date Date

B-Up Alarm B-Up Alarm

Brakes Brakes

Park Brake Park Brake

Fire Ext. Fire Ext.

Horn Horn

Seat Belt Seat Belt

Windows Windows

Mirrors Mirrors

Wipers Wipers

Defroster Defroster

Engine Engine

Fuel Tank Fuel Tank

Heater Heater

Hydraulics Hydraulics

Lights Lights

Steering Steering

Tires Tires

LIST ANY REPAIRS NEEDED: LIST ANY REPAIRS NEEDED:

MOBILE EQUIPMENT PRE-OPERATION INSPECTION 

81
MOBILE EQUIPMENT PRE-OPERATION EXAM

Equipment ____________________________Date ___________ 

Tires, linkage, u-joints ___________________________________

Handholds, ladder, steps _________________________________

Door Latches__________________________________________

ROPS________________________________________________ 

Mirrors ______________________________________________ 

Seat belts – clean, latches properly _________________________

Lights, wipers, gauges – operational ________________________ 

Windshield, cab glass – good visibility _____________________ 

Reverse alarm, horn – operational _________________________ 

Service/foot brake – stop loaded on maximum grade ___________

Parking brake – hold stopped vehicle _______________________

Comments 

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

30 CFR 56/57 14.100

82
EQUIPMENT NAME: MONTH:

DATE

Oil

Water

Fuel

Brake Fluid

Belts

Mirrors

Windows

Tires

Brakes

Emergency Brake

Hoses / Air Leaks

Fire Extinguisher

Frame

Pins

Access

Lights

Seat Belt

Horn

Back up Alarm

Operator Initial

LIST REPAIRS NEEDED

DAILY SAFETY CHECKLIST 

83
DAILY CHECKSHEET Motor Grader

14G

HOUR METER START:

UNIT # : HOUR METER END: DATE:_________________

OPERATOR :

ITEM TASK CHECK INFORMATION

ENGINE CHECK LEVEL & FOR LEAKS 15W40

ALL VEE BELTS CONDITION CHECK CONDITION Report defects

AIR FILTER CHECK INDICATOR Replace as required

RADIATOR CHECK LEVEL & FOR LEAKS 50 / 50 Mixture

FUEL TANK CHECK LINES & TANK LEVEL Inspect for leaks

HYDRAULIC LEVEL CHECK LEVEL / LEAKS Mobil Hydraulic Oil

FIRE EXTINGUISHER SEALS CHECK CONDITION Replace as required

TIRES & WHEELS CHECK FOR LOOSE NUTS Check Tire Condition & Report 

CHECK CYLINDER PINS CHECK FOR TAKING GREASE Visual Inspect Points & Cannister Level

BLADE CHECK CONDITION Check Pins for Grease

CYLINDERS & HOSES CHECK FOR LEAKS / DAMAGE Report Defects

SEAT & SEAT BELT CHECK CONDITION Report Defects

WARNING LAMPS & HORN CHECK OPERATION Report Defects

GAUGES CHECK OPERATION Report defects

LIGHTS CHECK ALL Repair as required

BACK-UP ALARM CHECK B/U Alarm & Horn Test Operation

SHIFT LINKAGES CHECK OPERATION Report Defects

CONTROLS & STEERING CHECK OPERATION Report defects

BRAKES CHECK PARKING & SERVICE Service Brake-2nd Fwd. P.Brake 3rd Fwd.

CONDITION OF UNIT WINDOWS, DOORS, BODY ETC. Report any Damage or defects

IS YOUR UNIT CLEAN AND SAFE !! IF NOT HAVE CORRECTED IMMEDIATELY

COMMENTS:

84
DAILY CHECKSHEET Caterpillar 771D TRUCK

Haul Truck

HOUR METER START:

UNIT # : HOUR METER END: DATE:_________________

OPERATOR :

ITEM TASK CHECK INFORMATION

ENGINE CHECK LEVEL & FOR LEAKS 15W40

ALL VEE BELTS CONDITION CHECK CONDITION Report defects

AIR FILTER CHECK INDICATOR Replace as required

RADIATOR CHECK LEVEL & FOR LEAKS 50 / 50 Mixture

FUEL TANK CHECK LINES & TANK LEVEL Inspect for leaks

HYDRAULIC LEVEL CHECK LEVEL / LEAKS Mobil Hydraulic Oil

STEERING TANK LEVEL CHECK LEVEL INSPECT FOR LEAKS

AUXILIARY STEERING TEST OPERATION REPORT DEFECTS

FIRE EXTINGUISHER SEALS CHECK CONDITION Replace as required

TIRES & WHEELS CHECK FOR LOOSE NUTS Check Tire Condition & Report 

CHECK CYLINDER PINS CHECK FOR TAKING GREASE Visual Inspect Points & Cannister Level

ROCK BOX & TAIL GATES CHECK CONDITION Check Pins for Grease

CYLINDERS & HOSES CHECK FOR LEAKS / DAMAGE Report Defects

SEAT & SEAT BELT CHECK CONDITION Report Defects

WARNING LAMPS & HORN CHECK CMS OPERATION Report Defects

GAUGES CHECK OPERATION Report defects

LIGHTS CHECK ALL Repair as required

BACK-UP ALARM CHECK B/U Alarm & Horn Test Operation

SHIFT LINKAGES CHECK OPERATION Report Defects

CONTROLS & STEERING CHECK OPERATION Report defects

BRAKES CHECK PARKING & SERVICE Test Operation of Both

TRANSMISSION CHECK LEVEL/RUNNING Mobil Transmission oil

CONDITION OF UNIT WINDOWS, DOORS, BODY ETC. Report any Damage or defects

IS YOUR UNIT CLEAN AND SAFE !! IF NOT HAVE CORRECTED IMMEDIATELY

COMMENTS:

85
DAILY CHECKSHEET Caterpillar 980G 

Front End Loader

HOUR METER START:

UNIT # : HOUR METER END: DATE:_________________

OPERATOR :

ITEM TASK CHECK INFORMATION

ENGINE CHECK LEVEL & FOR LEAKS 15W40

ALL VEE BELTS CONDITION CHECK CONDITION Report defects

AIR FILTER CHECK INDICATOR Replace as required

RADIATOR CHECK LEVEL & FOR LEAKS 50 / 50 Mixture

FUEL TANK CHECK LINES & TANK LEVEL Inspect for leaks

HYDRAULIC LEVEL CHECK LEVEL / LEAKS Mobil Hydraulic Oil

FIRE EXTINGUISHER SEALS CHECK CONDITION Replace as required

TIRES & WHEELS CHECK FOR LOOSE NUTS Check Tire Condition & Report 

CHECK CYLINDER PINS CHECK FOR TAKING GREASE Visual Inspect Points & Cannister Level

BUCKET CHECK CONDITION Check Pins for Grease

CYLINDERS & HOSES CHECK FOR LEAKS / DAMAGE Report Defects

SEAT & SEAT BELT CHECK CONDITION Report Defects

WARNING LAMPS & HORN CHECK OPERATION Report Defects

GAUGES CHECK OPERATION Report defects

LIGHTS CHECK ALL Repair as required

BACK-UP ALARM CHECK B/U Alarm & Horn Test Operation

SHIFT LINKAGES CHECK OPERATION Report Defects

CONTROLS & STEERING CHECK OPERATION Report defects

BRAKES CHECK PARKING & SERVICE Service Brake-2nd Fwd. P.Brake 3rd Fwd.

TRANSMISSION CHECK LEVEL/RUNNING Mobil Transmission oil HD30

CONDITION OF UNIT WINDOWS, DOORS, BODY ETC. Report any Damage or defects

IS YOUR UNIT CLEAN AND SAFE !! IF NOT HAVE CORRECTED IMMEDIATELY

COMMENTS:

86
87

Working Places Examination

§56.18002 Examination of working places.

https://www.msha.gov/regulations/rulemaking/examinations-working-places-metal-and-nonmetal-mines
30 CFR § 56.18010 First Aid 

An individual capable of providing first aid shall be available on all shifts. The individual shall 

be currently trained and have the skills to perform patient assessment and artificial respiration; 

control bleeding; and treat shock, wounds, burns, and musculoskeletal injuries. First aid training 

shall be made available to all interested miners. 

30 CFR § 56.15001 First-aid materials.

Adequate first-aid materials, including stretchers and blankets, shall be provided at places 

convenient to all working areas. Water or neutralizing agents shall be available where corrosive 

chemicals or other harmful substances are stored, handled, or used. 

Program Policy Manual

56/57.15001 First Aid Materials

This standard requires that adequate first-aid materials, including stretchers and blankets, shall be 

provided at places convenient to all working areas, and that water or neutralizing agents shall be 

available where corrosive chemicals or other harmful substances are stored, handled or used. 

The purpose of this mandatory standard is to ensure that adequate first-aid materials, including 

eye wash solution, safety showers (not just "deluge" showers, but a constant warm water supply 

for long-term flushing) and other neutralizing agents are available to workers where corrosive 

chemicals or other harmful substances are stored, handled, or used. Neutralizing agents shall be 

readily available for first-aid treatment and cleanup of corrosive chemical spillage or leakage. 

Spill-control products are commercially available for all hazardous chemical substances. 

These products both absorb and neutralize hazardous chemicals, thereby reducing the hazard to 

workers while containing the spilled chemicals. 

56.18012 Emergency telephone numbers.

Emergency telephone numbers shall be posted at appropriate telephones. 

56.18013 Emergency communications system.

A suitable communication system shall be provided at the mine to obtain assistance in the event 

of an emergency.

56.18014 Emergency medical assistance and transportation. 

Arrangements shall be made in advance for obtaining emergency medical assistance and 

transportation for injured persons. 

88
30 CFR Part 62 Hearing Conservation Program

GENERAL COMPANY INFORMATION

MSHA ID 

Number:

Company Name:

Company 

Address: 

City, State & Zip 

Code:

Mine Name:

Person responsible for health and safety training at the mine (Name and Position)

Responsible 

Person:

Position/Title:

Phone Number:

E-mail

(optional):

The attached Hearing Conservation Program complies with the following subparts of 30 CFR: 

62.110 - Noise Exposure Assessment 

62.160 - Hearing Protectors

62.170 thru 62.175 - Audiometric Testing

62.80 - Training

62.190 - Records

89
62.110-Noise Exposure Assessment

Noise Exposure Assessment

At least one of the fol owing method(s) will be used to assess employee exposure to n oise

(All that apply are checked):

1. Company self assessment using a Sound Level Meter.

2. Company self-assessment using a Noise Dosimeter.

3. Mine Safety &Health Administration (MSHA) compliance sampling data. (Copies of

all such data will be included in records kept for this Hearing Conservation

Program.)

4. Equipment manufacturer's noise specifications. (Copies of all,such data will be

included in records kept for this Hearing Conservation Program.)

Observation of Monitoring

This mine will provide the miners and their representatives with an opportunity to 

observe noise exposure monitoring and will give them prior notice.of the date and time

monitoring will take place.

Miner Notification of Exposure

This mine will notify a miner in writing within 15 days when his or her noise exposure 

equals or exceeds the '

action level, permissible exposure level or dual hearing protection 

level (provided this mine has not notified the miner of a similar exposure within the prior 

12 months.) A record of notification will be kept at the mine for at least 6 months or until the 

overexposure situation is corrected.

90
62.160 Hearing Protectors

Hearing Protectors

The following two Hearing Protection Devices will be routinely offered (at no cost) to employees 

requiring such devices at this company. 

Hearing protection Device #1

Type:

 In-Ear (Ear Plug) Over-the-Ear (Ear Muff) Ear Canal Cap

Other (Describe:)

Manufacturer: 

Ordering 

Information:

Hearing protection Device #2

Type:

 In-Ear (Ear Plug) Over-the-Ear (Ear Muff) Ear Canal Cap

Other (Describe:)

Manufacturer: 

Ordering 

Information:

In the event that the employee has a medical condition that prevents the use of the original choices offered the 

following additional choices will be made available.

Hearing Protection Deice - Alternate #1 

Type:

 In-Ear (Ear Plug) Over-the-Ear (Ear Muff) Ear Canal Cap

Other (Describe:)

Manufacturer: 

Ordering 

Information:

Hearing Protection Device - Alternate #2

Other devices recommended by the physician who determined that the original choices were 

not suitable. 

Hearing Protector Training

Training will be done on provided hearing protectors within 30 days of enrollment in the

Hearing Conservation Program and thereafter, during annual refresher training. 

91
62.170 thru 62.175 - Audiometric Testing

Audiometric testing will be offered to employees whose noise exposure is at or above the 

Action Level. The choice checked below reflects this mine'

s policy on requiring audiometric 

testing. 

 This mine requires baseline audiometric testing as a condition of employment. 

 This mine does nbt require a baseline audiometric test as a condition of employment. 

Baseline audiometric testing will be provided within 6 months of enrollment in the Hearing 

Conservation Program (12 months if mobile lab is used.) The choice checked below reflects this 

mine's policy on audiometric testing.

 Audiometric testing will be performed by our mine operation. The following is the name of 

the qualified Audiometric testing person:

 The following Audiometric Testing Service will be used for testing of our employees.

Name of Audiometric Testing Service:

Address:

Other Contact information:

Audiometric testing will be offered annually to all employees who have been baseline tested. 

Employee Notification

(Sample Notification Letters are in the Forms Appendix.)

Within 10 working days of receiving the results of an audiogram, or of a follow-up evaluation 

required under § 62.173 of Part 62, this mine will notify the miner in writing of the following:

1. The results and interpretation of the audiometric test, including any finding of a

standard threshold shift or reportable hearing loss; and

2. The need and reasons for any further testing or evaluation, if applicable.

Note: When evaluations of the audiogram shows that a miner has incurred a reportable hearing 

loss as defined in Part 62, this mine will report such loss to MSHA as a noise-induced hearing 

loss in, accordance with part 50 of 30 CFR. (Unless a physician or audiologist has determined 

that the loss is neither work-related nor aggravated by occupational noise exposure.) 

92
62.110(d)(e) Notification Letter - - Exposure at or above AL

This is not an official MSHA form. Part 62 does not specify the format for notification 

letters. Mine operators may use any format they wish for such letters. 

Date

John Jones

Employee Number 24689753 

Loader Operator

RE: Your Workplace Noise Exposure 

On Thursday, May 10, 2001, you were sampled for noise exposure while you operated 

the #4 Cat loader feeding the plant hopper. Your full shift noise exposure did not exceed 

MSHA’s Permissible Exposure Level, however your noise dose of 85 dba did exceed 

MSHA’s Action Level for noise exposure. The Action Level for noise exposure is onehalf of the Permissible Exposure Limit.

Because of this noise exposure, you have been enrolled in the company’s Hearing 

Conservation Program (HCP). By following the provisions of the HCP, your chances of 

sustaining a serious hearing loss as a result of on-the-job noise exposure will be greatly 

reduced. Within the next 30 days, you will be provided with hearing conservation training

(62.180), be offered audiometric testing (62.170(a)(1)) and offered your choice of either 

ear muffs or ear plugs (62.160(a)(2)). 

If you have any questions, please feel free to contact me or your supervisor. 

Sincerely,

John Smith 

General Manager

NOTE: Miners exposed at or above the Action Level, Permissible Exposure Level, or 

Dual Hearing Protection Level must be notified in writing within 15 days of: 

1. The exposure determination, and

2. The corrective action being taken.

62.110(e) The mine operator must maintain a copy of the miner notification, or a list 

on which the relevant information is recorded for the duration of the miner’s 

exposure at or above the Action Level plus 6 months. 

93
62.171(c) Baseline Audiometric Test Record

This is not an official MSHA form. Part 62 does not specify recordkeeping format. Mine 

operators may use any records format they wish. 

62.171(b)(1) 

Employee Name

62.171(b)(1) 

Job 

Classification

Date 

Enrolled In 

Hearing 

Conservatio

n Program

62.171(b)(2) Baseline Audiometric Test...copy of all of 

the miner's audiograms

Date

Offered

Offer

Accepted (A)

Declined (D)

Date Of Valid 

Baseline Test

Indicate

If Mobile 

Lab Used

94
62.171(c) Annual Audiometric Test Record

This is not an official MSHA form. Part 62 does not specify recordkeeping format. 

Mine operators may use any records format they wish. 62.171(b)(2) ...copy of all of the miner's audiograms 

62.171(b)(1) 

Employee Name

62.171(b)(1) 

Job 

Classification

Date 

Offered

Offer

Accepted (A)

Declined (D)

Date Of 

Annual 

Audiometric 

Test

Date 

Offered

Offer

Accepted (A)

Declined (D)

Date Of 

Annual 

Audiometric 

Test

Date 

Offered

Offer

Accepted (A)

Declined (D)

Date Of 

Annual 

Audiometric 

Test

62.175(b) When evaluation of the audiogram shows that a miner has incurred a reportable hearing loss as defined in this part, 

the mine operator must report such loss to MSHA as a noise-induced hearing loss in accordance with part 50 of this title, 

unless a physician or audiologist has determined that the loss is neither work-related nor aggravated by occupational noise 

exposure.

95
62.180 Training

Within 30 days of a miner's enrollment into the Hearing Conservation Program, this 

mine will provide the miner with training. This mine operation will give training every 

12 months thereafter if the miner's noise exposure continues to equal or exceed the 

action level. Training will include:

1. The effects of noise on hearing.

2. The purpose and value of wearing hearing protectors.

3. The advantages and disadvantages of the hearing protectors to be offered.

4. The various tyes of hearing protectors offered by the mine operator and the

care, fitting, and use of each type.

5. The general requirements of this standard.

6. The mine operator's and miner's respective tasks in controlling the miner's

exposure to noise.

7. The purpose and value of audiometric testing and a summary of the

procedures.

This mine will certify the date and type of training given each miner, and maintain a 

record of this training for as long as the miner is enrolled in the Hearing Conservation

Program, and for at least 6 months thereafter. (Sample Training Certificates are in the 

Forms Appendix.)

96
62.180(b) Hearing Conservation Program Training Record

MINE NAME MSHA ID#_____________ 

This is not an official MSHA training form. This form is being provided to assist the mine 

operator in documenting “Hearing Conservation Program” training requirements. Part 62 does 

not specify what form to use for documenting training. 

Miner’s Full Name (print): _____________________________________________ 

Miner’s Job Title:_____________________________________________________ 

30 CFR Part 62.180 Training

§62.180(a) The mine operator must, within 30 days of a miner’s enrollment

into a hearing conservation program, provide the miner with training. The

mine operator must give training every 12 months thereafter if the miner’s

noise exposure continues to equal or exceed the action level. Training must

include:

Check 4

if completed

Miner’s 

Initials 

(optional)

§ 62.180(a)(1) The effects of noise on hearing;

§ 62.180(a)(2) The purpose and value of wearing hearing protectors;

§ 62.180(a)(3) The advantages and disadvantages of the hearing protectors

offered;

§ 62.180(a)(4) The various types of hearing protectors offered by the mine

operator and the care, fitting and use of each type;

§ 62.180(a)(5) The general requirements of this part;

§ 62.180(a)(6) The operator’s and miner’s respective task in maintaining

mine noise controls; and

§ 62.180(a)(7) The purpose and value of audiometric testing and a summary

of the procedures.

Optional Training 

List all additional training provided on the companies “Hearing 

Conservation Program” in the space below.

Miner’s 

Initials 

(optional)

1)

2)

3)

4)

As required by §62.180(b), I certify that the above training has been completed. 

___________________________________________________________________ 

(Signature of person responsible training) (Date training provided) 

97
Link to Part 100 Criteria for Assessments

98

Part 100

File a Complaint - SBA Ombudsman
DIRECTIONS FOR USING THE SELF AUDIT

This safety audit consists of descriptions of safety and health standards for aggregated 

operations. The first column consists of the description of the regulation with questions (second 

column) that correspond to that regulation. In some cases only one question may be necessary, in 

others several questions may be necessary for the description. 

Responses should fall into three categories, (YES) (NO) and (N/A). If you answer (YES) 

generally no further action is necessary.

A (NO) response generally will require further action and an explanation of the defective 

condition/location/practice. If you answer (NO) to any question, further action will be necessary 

and you should complete the column (Corrective Action) and indicate action taken or flag this 

area for corrective action. In order to make this audit a positive vehicle for improving safety at 

your mining operation, any (NO) answer should include a corrective date entry (the last column 

on the audit). 

Check (N/A) if the description is not applicable to your operation. 

Link to Most Frequently Cited Standards by Mine Type

99
DESCRIPTION Y

E

S

N

O

N

/

A

CORRECTIVE 

ACTION 

NEEDED

STANDARD DATE 

RESOLVED

HAZARD COMMUNICATION (HAZCOM)

Requirement 

for container 

labels

The operator must ensure that 

each container of a hazardous 

chemical has a label. If a 

container is tagged or marked 

with the appropriate information, 

it is labeled. 47.41(a) 

REPORTING OF ACCIDENTS, INJURIES, AND ILLNESSES

Preparation 

and 

Submission 

of MSHA 

Report Form 

7000-1 

Is Form 7000-1 (Mine Accident, 

Injury, and Illness Report) 

completed and submitted to 

MSHA within ten working days 

after an accident or occupational 

injury occurs or an occupational 

illness is diagnosed?

50.20 

QUARTERLY EMPLOYMENT AND COAL PRODUCTION REPORT

Preparation 

and 

Submission 

of MSHA 

Form 7000-2 

Is Form 7000-2 (Quarterly 

Employment and Coal Production 

Report) completed and submitted 

to the Office of Injury and 

Employment Information in 

Denver, Colorado within 15 days 

after the end of each quarter?

50.30(a) 

PROCEDURES

Notification 

of 

Commencement of 

Operations 

and Closing 

of Mines

Is MSHA and Metal/Nonmetal 

Mine Safety and Health District 

office notified before starting 

operations?

56.1000 

Is MSHA and Metal/Nonmetal 

Mine Safety and Health District 

office notified when a mine is 

closed?

100
DESCRIPTION Y

E

S

N

O

N

/

A

CORRECTIVE 

ACTION 

NEEDED

STANDARD DATE 

RESOLVED

PROHIBITIONS/PRECAUTIONS/HOUSEKEEPING

Warning 

Signs

Are readily visible signs 

prohibiting smoking and open 

flames posted where a fire or 

explosion hazard exists?

56.4101 

SAFETY DEVICES, PROVISIONS, AND PROCEDURES FOR ROADWAYS, RAILROADS, 

LOADING, AND DUMPING SITES

Berms or 

Guardrails

Are adequate berms or guardrails 

provided and maintained on the 

outer banks of elevated 

roadways?

56.9300(a)

TRAVELWAYS

Safe Access Is safe means of access provided 

and maintained to all working 

places (includes access to service 

equipment)?

56.11001 

Protection 

for openings 

around 

travelways 

Openings above, below, or near 

travelways through which persons 

or materials may fall shall be 

protected by railings, barriers, or 

covers. Where it is impractical to 

install such protective devices, 

adequate warning signals shall be 

installed.

56.11012 

Handrails 

and Toe 

Boards 

Are substantially constructed 

handrails provided and 

maintained on crossovers, 

elevated walkways, elevated 

ramps, and stairways?

56.11002 

Are toe boards provided where 

necessary?

101
DESCRIPTION Y

E

S

N

O

N

/

A

CORRECTIVE 

ACTION 

NEEDED

STANDARD DATE 

RESOLVED

ELECTRICITY

Electrical 

Conductors

Are electrical conductors (power 

cables) protected from mechanical 

damage?

Are the electrical conductors 56.12004 

sufficient in size and current 

carrying capacity to prevent 

overheating or damage to the 

insulating cover?

Insulation 

and Fittings 

for Power 

Wires and 

Cable 

Entrance

Are the power wires and cables 

adequately insulated where they 

pass into or out of electrical 

compartments?

56.12008 

Are cables entering metal frames 

of motors, splice boxes, and 

electrical compartments, through 

proper fittings and bushings?

Identification 

of power 

switches

Principal power switches shall be 

labeled to show which units they 

control, unless identification can 

be made readily by location

56.12018 

Circuit 

Enclosure

Grounding

Are all metal enclosing or metal 

encased electrical circuits 

grounded or provided with 

equivalent protection?

56.12025 

Testing 

Grounding 

Systems

Are grounding systems tested 

immediately after installation, 

repair, or modification, and 

annually thereafter?

56.12028 

Is a record of the most recent test 

available for inspection?

Correction of 

Dangerous 

Conditions

Are potentially dangerous 

electrical conditions corrected 

before the equipment or wiring is 

energized?

56.12030 

Inspection 

and Cover 

Plates

Are inspection and cover plates 

on electrical equipment and 

junction boxes?

56.12032

Guarding 

Around 

Lights

Are guards used where portable 

extension lights and other lights 

that by their location, present a 

shock or burn hazard?

56.12034

102
DESCRIPTION Y

E

S

N

O

N

/

A

CORRECTIVE 

ACTION 

NEEDED

STANDARD DATE 

RESOLVED

MACHINERY AND EQUIPMENT

Safety 

Defects, 

Examination, 

Correction, 

and Records

Are defects that affect safety 

corrected in a timely manner? 56.14100(b) 

Brakes Is self propelled mobile 

equipment equipped with a 

service brake system capable of 

stopping and holding the 

equipment with its typical load on 

the maximum grade it travels? 

(Does not apply to rail 

equipment)

56.14101(a) 

(2)

Are parking brakes capable of 

holding self propelled mobile 

equipment with its typical load on 

the maximum grade?

Are all braking systems on self 

propelled mobile equipment 

installed and maintained in 

functional condition?

Moving 

Machine 

Parts

Are adequate guards provided to 

protect persons from contacting 

gears, sprockets, chains, drive, 

head, tail, and take up pulleys, 

flywheels, couplings, shafts, fan 

blades, and similar moving parts 

that can cause injury?

56.14107 

56.14107(a) 

Construction 

and 

Maintenance 

of Guards 

Are guards securely in place when 

equipment is operating? 56.14112(a) 

(1) (2), and

(b)

Are guards constructed to 

withstand vibration, shock, and 

wear to which they will be 

subjected to during normal 

operation?

Horns and 

Backup 

Alarms

Are manually operated horns or 

other audible warning devices 

provided on self propelled mobile 

equipment?

56.14132 

56.14132(a) 

Does self propelled mobile 

equipment have automatic reverse 

activated signal alarm?

103
DESCRIPTION Y

E

S

N

O

N

/

A

CORRECTIVE 

ACTION 

NEEDED

STANDARD DATE 

RESOLVED

COMPRESSED AIR AND BOILERS

High 

Pressure 

Hose 

Connections 

Are safety chains or other suitable 

locking devices used at 

connections to machines of high 

pressure hose lines of 3/4” inside 

diameter or larger where a 

connection failure would create a 

hazard?

56.13021 

PERSONAL PROTECTION

Safety Belts 

and Lines

Do persons wear safety belts and 

lines where there is a danger of 

falling? 56.15005 

Are approved safety belts and 

safety lines readily available?

Does a second person tend a 

lifeline when bins, tank, or other 

dangerous areas are entered?

MATERIAL STORAGE AND HANDLING

Securing Gas 

Cylinders

Are compressed and liquid gas 

cylinders secured in a safe 

manner?

56.16005

Protection of 

Gas Cylinder 

Valves 

Are valves on compressed gas 

cylinders protected by covers 

when being transported or stored? 56.16006 

Are cylinders placed in a safe 

location when in use?

Examination 

of Working 

Places 

(Workplace 

Safety 

Record)

A record that such examinations 

were conducted shall be kept by 

the operator for a period of one 

year, and shall be made available 

for review by the Secretary or his 

authorized representative

56.18002(b) 

ILLUMINATION

Illumination 

of surface 

working 

areas.

Is illumination sufficient to 

provide safe working conditions 

in and on all surface structures, 

paths, walkways, stairways, 

switch panels, loading and 

dumping sites, and work areas?

56.17001 

104
DESCRIPTION Y

E

S

N

O

N

/

A

CORRECTIVE 

ACTION 

NEEDED

STANDARD DATE 

RESOLVED

SAFETY PROGRAMS

First Aid Is an individual capable of 

providing first aid available on all 

shifts?

56.18010

Is first aid training made available 

to all interested miners?

Housekeeping Are workplaces, passageways, 

storerooms, and service rooms 

kept clean and orderly? 56.20003(a) 

56.20003(b) Are floors of every workplace 

maintained in a clean and dry 

condition?

Is every floor, working place, and 

passageway kept free from 

protruding nails, splinters, holes, 

or loose boards?

FIREFIGHTING EQUIPMENT

Inspection

Firefighting equipment shall be 

inspected according to the 

following schedules:

56.4201(a) (2) 

At least once every twelve 

months, maintenance checks shall 

be made of mechanical parts, the 

amount and condition of 

extinguishing agent and expellant, 

and the condition of the hose, 

nozzle, and vessel to determine 

that the fire extinguishers will 

operate effectively.

At least once every twelve 

months, maintenance checks shall 

be made of mechanical parts, the 

amount and condition of 

extinguishing agent and expellant, 

and the condition of the hose, 

nozzle, and vessel to determine 

that the fire extinguishers will 

operate effectively.

105
DESCRIPTION Y

E

S

N

O

N

/

A

CORRECTIVE 

ACTION 

NEEDED

STANDARD DATE 

RESOLVED

AIR QUALITY AND PHYSICIAL AGENTS

Exposure 

limits for 

airborne 

contaminants

Except as provided in paragraph 

(b) of this section, the exposure to

airborne contaminants shall not

exceed, on the basis of a time

weighted average, the threshold

limit values adopted by the

American Conference of

Governmental Industrial

Hygienists, as set forth and

explained in the 1973 edition of

the Conference's publication,

entitled "TLV's Threshold Limit

Values for Chemical Substances

in Workroom Air Adopted by

ACGIH for 1973," pages 1

through 54, which are hereby

incorporated by reference and

made a part hereof. This

publication may be obtained from

the American Conference of

Governmental industrial

Hygienists by writing to the

Secretary-Treasurer, P.O Box

1937, Cincinnati, Ohio 45201, or

may be examined in any Metal

and Nonmetal Mine Safety and

Health District Office of the Mine

Safety and Health Administration.

Excursions above the listed

thresholds shall not be of a greater

magnitude than is characterized as

permissible by the Conference

56.5001(a)/ 

56.5005 

OCCUPATIONAL NOISE EXPOSURE

Action Level If during any work shift a miner’s 

noise exposure equals or exceeds 

the action level, is the miner 

enrolled in a hearing conservation 

program?0

62.120 

Permissible 

Exposure 

Level

If during any work shift a miner’s 

noise exposure exceeds the 

permissible exposure level, are all 

feasible engineering and 

administrative controls to reduce 

the noise exposure used?

62.130(a) 

106
107

Guarding

Link to MSHA's Guide to 

Equipment Guarding OT 3
108

Miners Rights 

Link to Miners Rights 

Link to Miners Representatives Guide 

Link to Representative to Miners 

Designation Form 
109

JOSEPH A. HOLMES SAFETY ASSOCIATION
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Educational Field and Small Mine Services
111

Link to State Grants 

MSHA State Grants Program: Under Section 503 of the Federal 

Mine Safety and Health Act of 1977 (Mine Act), Public Law 95-164, as 

amended, the Secretary of Labor through the Mine Safety and Health 

Administration (MSHA) may award grants to States to assist them in 

developing and enforcing State mining laws and regulations, to 

improve State workers' compensation and mining occupational disease 

laws and programs, and to improve safety and health conditions in the 

Nation's mines through Federal-State coordination and 

cooperation.MSHA recognizes that State training programs are the 

"front line" source of mine safety and health training and education of 

individuals who work or will work at mines. MSHA encourages State 

training programs, as a priority, to focus their efforts on small mining 

operations. Also, MSHA is interested in supporting programs that 

include training on miners' statutory rights, including the right to be 

provided a safe working environment and the right to refuse to perform 

an unsafe task. The Agency also encourages recipients to focus on 

programs which include education and training related to occupational 

health hazards and diseases (such as black lung and silicosis), mine 

emergency evacuation training and drills (including donning and 

transferring self-contained self-rescuers (SCSRs)), and mine rescue team 

training.
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Additional Resources

Link to Training Videos 

Link to Toolbox Talks

Link to Mining Aggregates Safety Video

Link to Dredging Safety Video

Link to IG 40 

Link to IG 41