Mine Rescue Teams, Arrangements for Emergency Medical Assistance, and Arrangements for Transportation for Injured Persons

Forms and Documents

Document Name	Status
Form 5000-3 Mine Rescue Teams; Arrangements for Emergency Medical Assistance; and Arrangements for Transportation for Injured Persons Form and Instruction	Modified
1219-0078 Supporting Statement 2016.doc Supporting Statement A	2016-03-16
1219-0078 PUBLISHED FRN 9-23-15 v80.pdf Supplementary Document	2015-12-14

IC Document Collections

IC ID	Document Title	Status
14446	Mine Rescue Teams; Arrangements for Emergency Medical Assistance; and Arrangements for Transportation for Injured Persons Form and Instruction	Modified

ICR Details

OMB Control No: 1219-0078	ICR Reference No: 201508-1219-004
Status: Historical Active	Previous ICR Reference No: 201208-1219-006
Agency/Subagency: DOL/MSHA	Agency Tracking No:
Title: Mine Rescue Teams, Arrangements for Emergency Medical Assistance, and Arrangements for Transportation for Injured Persons
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/03/2016
	Date Received in OIRA: 03/19/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	12/31/2016	05/31/2016
Responses	20,041	0	20,043
Time Burden (Hours)	10,109	0	10,111
Cost Burden (Dollars)	309,067	0	309,067

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Abstract: Paperwork requirements supporting 30 CFR 49 regarding the availability of mine rescue teams; alternate mine rescue capability for small and remote mines and mines with special mining conditions; inspection and maintenance records of mine rescue equipment and apparatus; physical requirements for team members and alternates; and experience and training requirements for team members and alternates are contained in this information collection.

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Authorizing Statute(s): US Code: 30 USC 813(h) Name of Law: Federal Mine Safety and Health Act of 1977
   US Code: 30 USC 811(a) Name of Law: Federal Mine Safety and Health Act of 1977
   US Code: 30 USC 825(e) Name of Law: Federal Mine Safety and Health Act of 1977
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 57398	09/23/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 14893	03/18/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Mine Rescue Teams; Arrangements for Emergency Medical Assistance; and Arrangements for Transportation for Injured Persons	5000-3	Certificate of Physical Qualification for Mine Rescue Work

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	20,041	20,043	0	0	-2	0
Annual Time Burden (Hours)	10,109	10,111	0	0	-2	0
Annual Cost Burden (Dollars)	309,067	309,067	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Respondents: There was a decrease of 39 respondents (from 254 to 215) due to a decrease in the number of underground M/NM mines. Responses: There was a decrease of 2 (from 20,043 to 20,041) due to due to a decrease in the number of underground M/NM mines. Burden Hours: There was a decrease of 2 burden hours (10,111 to 10,109) due to due to a decrease in the number of underground M/NM mines. Cost Burden to Respondents or Record Keepers: There was no change. Costs remained at $309,067.

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Annual Cost to Federal Government: $1,841

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/19/2016

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