Mine Safety and Health Administration

MSHA

Federal Forms

Forms
OMB NumberTitle
1219-0155 Safety Program for Surface Mobile Equipment
1219-0154 Mine Safety and Health Administration Grant Performance Reports
1219-0153 Lowering Miners' Exposure to Coal Mine Dust Including Continuous Personal Dust Monitors
1219-0152 Periodic Medical Surveillance Examinations for Coal Miners
1219-0151 Cleanup Program for Accumulations of Coal and Float Coal Dusts, Loose Coal, and Other Combustibles
1219-0150 Pattern of Violations
1219-0149 Pilot Surveys of Employee Voice in the Coal Mining Industry
1219-0148 Proximity Detection Systems for Continuous Mining Machines in Underground Coal Mines
1219-0147 Coal Mine Dust Sampling Devices
1219-0146 Refuge Alternatives for Underground Coal Mines
1219-0145 Automatic Fire Sensor and Warning Device Systems; Examination and Test Requirements
1219-0144 Mine Rescue Teams; Arrangements for Emergency Medical Assistance and Transportation for Injured Persons; Agreements; Reporting Requirements; Posting Requirements
1219-0143 Qualification/Certification Program Request for MSHA Individual Identification Number (MIIN)
1219-0142 Sealing of Abandoned Areas
1219-0141 Emergency Mine Evacuation
1219-0140 High-Voltage Continuous Mining Machines Standards for Underground Coal Mines
1219-0138 Safety Standards for Underground Coal Mine Ventilation—Belt Entry Used as an Intake Air Course to Ventilate Working Sections and Areas Where Mechanized Mining Equipment is Being Installed or Removed
1219-0137 Emergency Evacuations and Mine Emergency Evaluations and Fire-fighting Program of Instruction
1219-0136 Testing and Evaluation by Independent Laboratories and Non-MSHA Product Safety Standards
1219-0135 Health Standards for Diesel Particulate Matter Exposure (Underground Metal and Nonmetal Mines)
1219-0133 Hazard Communication– 30 CFR Part 47
1219-0131 Training Plans, New Miner Training, Newly-hired Experienced Miner Training
1219-0128 Improving and Eliminating Regulations; Calibration and Respirable Dust Samples
1219-0127 Certification and Qualification to Examine, Test, Operate Hoists and Perform Other Duties
1219-0125 Safety Standards for Underground Coal Mine Ventilation (30 CFR 75.360(a)(1) and 75.360(f))
1219-0124 Health Standards for Diesel Particulate Matter Exposure (Underground Coal Mines)
1219-0123 Final Finding; Single, Full-Shift Respirable Dust Measurements 90.300, 90.301(d)
1219-0122 Observation of Noise Exposure Monitoring
1219-0121 Safety Standards for Roof Bolts in Metal and Nonmetal Mines and Underground Coal Mines
1219-0120 Occupational Noise Exposure
1219-0119 Diesel-Powered Equipment in Underground Coal Mines
1219-0118 TESTING AND EVALUATION BY NATIONALLY RECOGNIZED TESTING LABORATORIES AND USE OF EQUIVALENT TESTING AND EVALUATION REQUIREMENTS -- 30 CFR PART 6
1219-0117 ELECTRIC CABLES, SIGNALING CABLES, AND CABLE SPLICE KITS -- 30 CFR 7, 18, 57 AND 75
1219-0116 Examinations and Testing of Electrical Equipment, Including Examination, Testing, and Maintenance of High Voltage Longwalls
1219-0115 Approval Requirements for Electric Motor Assemblies (30 CFR 7.303)
1219-0108 SUBSTANCE ABUSE PROGRAMS IN THE MINING INDUSTRY
1219-0107 POSTING BURNING RATE OF SAFETY FUSE (30 CFR 56/57.6502)
1219-0106 QUALIFIED PERSON, EXPLOSIVES AND BLASTING (30 CFR 75.1301)
1219-0103 Notification of Methane Detected in Underground Metal and Nonmetal Mine Atmospheres
1219-0101 Applications for Approval of Sanitary Toilet Facilities (30 CFR 71.500 and 75.1712-6)
1219-0100 Product Testing by Applicant or Third Party
1219-0099 TORGUE TESTS OF ROOF BOLTS (UNDERGROUND COAL MINES) (30 CFR 75.200-7(B)(3)(III)
1219-0098 A DEMOGRAPHIC SURVEY OF THE MINING INDUSTRY POPULATION
1219-0097 Rock Burst Control Plan (Pertains to Underground Metal/Nonmetal Mines)
1219-0096 Underground Retorts
1219-0095 Explosive Materials and Blasting Units (pertains only to underground metal and Category III nonmetal mines deemed to be gassy)
1219-0093 MINE RESCUE EQUIPMENT TEST AND INSPECTION RECORDS -- 30 CFR 49.6
1219-0092 Notification of Commencement of Operations and Closing of Mines
1219-0089 Safety Defects; Examination, Correction, and Records
1219-0088 Ventilation Plans, Tests, and Examinations in Underground Coal Mines
1219-0087 INSPECTIONS OF FIREFIGHTING EQUIPMENT (30 CFR 55/56/57.4-23)
1219-0086 ROCK BOLT TEST PROCEDURES AND ROCK BOLT ANCHORAGE CAPACITY TESTS (30 CFR 56.3053 AND 57.3053)
1219-0085 FIRST AID TRAINING FOR SUPERVISORY EMPLOYEES (30 CFR 75.1713-3 & 77.1703)
1219-0084 VENTILATION SYSTEM AND METHANE AND DUST CONTROL PLAN 30 CFR 75.316 AND 75.316-1
1219-0083 Surface Coal Mines Daily Inspection; Certified Person; Reports of Inspection
1219-0082 Records of Preshift and Onshift Inspections of Slope and Shaft Areas of Slope and Shaft Areas of Slope and Shaft Sinking Operations at Coal Mines
1219-0081 WIRE ROPE DIAMETER MEASUREMENTS AND TESTS (30 CFR 55/56/57.19-22, 55/56/57.19-23(D), 75/77.1402-2, AND 75/77.1404-3(D))
1219-0080 TRADE-NAME CHEMICALS
1219-0078 Mine Rescue Teams, Arrangements for Emergency Medical Assistance, and Arrangements for Transportation for Injured Persons
1219-0077 TRAINING OF MINE RESCUE TEAMS -- 30 CFR 49.8
1219-0075 TEST AND EXAMINATION OF UNDERGROUND WORKING ENVIRONMENT
1219-0074 FIRE EXTINGUISHING AND ABANDONMENT PLANS FOR REFUSE PILES AND IMPOUNDMENTS (30 CFR 77.215(J), 77.215-4, 77.216(E) AND 77.216-5)
1219-0073 Mine Mapping and Records of Opening, Closing, and Reopening of Mines
1219-0072 CERTIFICATION OF ELECTRICAL EXPERIENCE
1219-0070 Certificate of Training (30 CFR 48.9 and 48.29)
1219-0069 Qualification and Certification Program
1219-0068 PHYSICAL QUALIFICATION FOR MINE RESCUE WORK
1219-0067 Examinations and Tests of Electrical Equipment (30 CFR 75.512, 75.703(d)(II), 77.502, 75.800, 77.900, 75.1001-1(c), and 75.351)
1219-0066 TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS, 30 CFR SUBCHAPTER B - PARTS 6 THROUGH 36
1219-0065 Petitions for Modification of Mandatory Safety Standards
1219-0064 SAFETY DEFECT RECORD OF SELF PROPELLED EQUIPMENT
1219-0063 INSPECTION RECORDS OF PRESSURE VESSEL GUAGES, DEVICES, AND PIPING
1219-0062 INSTRUCTION RECORDS FOR FIRE ALARM SIGNALS AND PROCEDURES
1219-0061 RADON DAUGHTER SAMPLING (30 CFR 57.5-37)
1219-0060 IMPOUNDMENT AND REFUSE PILE PLANS AND REVISIONS (30 CFR 77.215-2(A) AND (B)(1) THROUGH (3), 77.216, AND 77.216-2)
1219-0059 WORK SITE EXAMINATIONS FOR SAFETY AND HEALTH CONDITIONS
1219-0058 EMPLOYEE INSTRUCTION RECORD FOR ESCAPE, EVACUATION, FIRE ALARM SIGNALS, AND EMERGENCY PROCEDURES (UNDERGROUND)
1219-0057 INSTRUCTION RECORDS OF MINE EMERGENCY TRAINING AND SELF-RESCUER TRAINING
1219-0056 COMPRESSED AIR RECEIVERS AND PRESSURE VESSELS INSPECTION
1219-0055 MINE EVACUATION DRILL RECORDS
1219-0054 Underground Coal Mine Fire Protection
1219-0053 WEEKLY INSPECTIONS OF FIRE SUPPRESSION DEVICES (30 CFR 75.1107-16)
1219-0052 ESCAPEWAYS AND ESCAPE FACILITIES -- 30 CFR 75.1704-2
1219-0051 Escape and Evacuation Plans for Surface Coal Mines, Surface Facilities and Surface Work Areas of Underground Coal Mines
1219-0050 SEMI-ANNUAL INSPECTION OF FIRE ESTINGUISHERS
1219-0049 Hoist Operators' Physical Fitness
1219-0048 Respirator Program Records
1219-0047 MEDICAL EXAMINATIONS FOR MAN HOIST OPERATORS
1219-0046 Escape and Evacuation Plans
1219-0045 CHECK-IN, CHECK-OUT SYSTEM FOR UNDERGROUND PERSONNEL
1219-0044 Record of Results of Examinations of Self-Rescuers (Underground Coal Mines)
1219-0043 Identification of Independent Contractors
1219-0042 Representative of Miners, Notification of Legal Identity, and Notification of Commencement of Operations and Closing of Mines
1219-0041 Program to Prevent Smoking in Hazardous Areas of Underground Coal Mines
1219-0040 Independent Contractor Registration and Identification
1219-0039 Gamma Radiation Surveys
1219-0038 FIRST AID TRAINING SUPERVISORY EMPLOYEES 30 CFR SECTION 75.1713-3
1219-0037 Noise Data Report Form and Calibration Records -- 30 CFR 70.506, 70.507, 70.508, 70.509, 71.801, 71.803, and 70.804
1219-0036 REPORT OF EMERGENCY MEDICAL ASSISTANCE AND TRANSPORTATION OF INJURED PERSONS
1219-0035 ROCK BOLT TEST PROCEDURES AND ROCK BOLT ANCHORAGE CAPACITY TESTS
1219-0034 Records of Tests and of Examinations of Personnel Hoisting Equipment
1219-0033 RECORD OF PRESHIFT AND ONSHIFT INSPECTIONS
1219-0032 DAILY INSPECTION OF HOISTS RECORD
1219-0031 WEEKLY AIR FLOW MEASUREMENTS (30 CFR 57.21035)
1219-0030 Main Fan Operation and Inspection (I-A, II-A, III, and V-A mines)
1219-0029 HOIST AND SHAFT INSPECTION RECORDS
1219-0028 RECORD OF EXAMINATION OF HAZARDOUS CONDITIONS
1219-0027 ANNUAL FUNCTIONAL TEST AND WEEKLY INSPECTION OF FIRE SENSOR AND WARNING DEVICE SYSTEMS (30 CFR 75.1103-8)
1219-0026 Ground Control Plans for Surface Coal Mines and Surface Work Areas of Underground Coal Mines
1219-0025 Application for a Permit to Fire More than 20 Boreholes and/or for the Use of Nonpermissible Blasting Units, Explosives, and Shot-firing Units; Posting Notices of Misfires
1219-0024 Application for Waiver of Surface Sanitary Facilities’ Requirements (Pertaining to Coal Mines)
1219-0023 FIRE DOOR LOCATION PLANS FOR UNDERGROUND MINES AT LEVEL LANDINGS
1219-0022 MONTHLY TESTS OF MINE RESCUE APPARATUS
1219-0020 Operations Mining Under a Body of Water
1219-0019 Slope and Shaft Sinking Plans, 30 CFR 77.1900 (Pertains to the Surface Work Areas of Underground Coal Mines)
1219-0018 APPLICATIONS FOR APPROVAL OF SANITARY TOILET FACILITIES 30 CFR 75.1712-6
1219-0017 Hearing Conservation Plan -- 30 CFR 70.510 and 71.805
1219-0016 Ventilation Plan and Main Fan Maintenance Record
1219-0015 Refuse Piles and Impoundment Structures, Recordkeeping and Reporting Requirements
1219-0014 Hazardous Conditions Complaints
1219-0013 INSPECTIONS OF FIREFIGHTING EQUIPMENT
1219-0012 Main Fan Maintenance Record
1219-0011 Respirable Coal Mine Dust Sampling
1219-0009 Training Plans and Records of Training, for Underground Miners and Miners Working at Surface Mines and Surface Areas of Underground Mines
1219-0008 Notification of Legal Identity (30 CFR Section 41.10, 41.11, 41.12, and 41.20
1219-0007 Mine Accident, Injury, and Illness Report and Quarterly Mine Employment and Coal Production Report
1219-0006 Quarterly Mine Employment and Coal Production Report (30 CFR 50.30(a))
1219-0005 CONDITIONS IN THE ACTIVE WORKINGS OF THE COAL MINE
1219-0004 Roof Control Plans for Underground Coal Mines
1219-0003 Radiation Sampling and Exposure Records
1219-0002 ELECTRICALLY OPERATED MINING EQUIPMENT FIELD APPROVAL APPLICATION (COAL OPERATOR) (30 CFR 18.93 AND 18.94)
1219-0001 Certificate of Electrical Training and Applications for MSHA Approved Tests and State Tests Administered as Part of an MSHA-approved State Program

© 2022 OMB.report | Privacy Policy