Hoist Operators' Physical Fitness

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
MSHA-2017-0010-0001.pdf	Supplementary Document	Uploaded 2017-06-20	Available
1219-0049 Supporting Statement 3-2017.doc	Supporting Statement A	Uploaded 2017-06-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
14420	Hoist Operators' Physical Fitness		Modified

ICR Details

OMB Control No: 1219-0049	ICR Reference No: 201706-1219-004
Status: Active	Previous ICR Reference No: 201404-1219-004
Agency/Subagency: DOL/MSHA	Agency Tracking No:
Title: Hoist Operators' Physical Fitness
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: 11/15/2017
	Date Received in OIRA: 09/12/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved	11/30/2017
Responses	575	0	375
Time Burden (Hours)	19	0	13
Cost Burden (Dollars)	182,275	0	187,500

---

Abstract: Title 30 CFR 56.19057 and 57.19057 require the annual examination and certification of hoist operators' fitness by a qualified, licensed physician.

---

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

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 17695	04/12/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 42838	09/12/2017
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Hoist Operators' Physical Fitness

---

ICR Summary of Burden

table that charts list 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	575	375	0	0	200	0
Annual Time Burden (Hours)	19	13	0	0	6	0
Annual Cost Burden (Dollars)	182,275	187,500	0	0	-5,225	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: The burden hours increased from 13 to 19 hours, and responses increased from 375 to 575 due to an increase in the number of mines from 75 to 115. Costs to respondents decreased from $187,500 to $182,275 because the cost of the examinations in item 13 decreased from $500 to $317 per examination due to use of federal medical health cost statistics.

---

Annual Cost to Federal Government: $0

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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

---

Common Form ICR:  No

---

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: 09/12/2017

---