Certification and Qualification to Examine, Test, Operate Hoists, and to Perform Other Duties

Certification and Qualification to Examine, Test, Operate Hoists, and to Perform Other Duties

OMB: 1219-0127

IC ID: 14507

Information Collection (IC) Details

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Certification and Qualification to Examine, Test, Operate Hoists, and to Perform Other Duties
 
No Modified
 
Mandatory
 
30 CFR 75.159 30 CFR 75.160 30 CFR 77.106 30 CFR 75.100 30 CFR 75.161 30 CFR 77.100 30 CFR 77.105 30 CFR 75.155 30 CFR 77.107 30 CFR 77.107-1

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form MSHA Form 5000-41 Safety and Health Activity Certification or Hoisting Engineers Qualification Request 5000-41.pdf http://www.msha.gov/forms/elawsforms/5000-41.htm Yes Yes Fillable Fileable
Form and Instruction MSHA Form 5000-41 Safety and Health Activity Certification or Hoisting Engineers Qualification Request 5000-41_screenshots.docx http://www.msha.gov/forms/elawsforms/5000-41.htm Yes Yes Fillable Fileable Signable
Instruction Form 5000-41 Intro Screen.pdf http://www.msha.gov/forms/elawsforms/5000-41.htm Yes Yes Fillable Fileable

Workforce Management Worker Safety

DOL/MSHA-15 Health & Safety Training and Examination Records  67 FR 16815

1,232 0
   
Private Sector Businesses or other for-profits
 
   80 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 5,659 0 0 -1,307 0 6,966
Annual IC Time Burden (Hours) 548 0 0 -131 0 679
Annual IC Cost Burden (Dollars) 71 0 0 -54 0 125

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