Emergency Mine Evacuation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0141 can be found here:

Documents and Forms

Document Name Document Type
Form MSHA Form 2000-222 Emergency Mine Evacuation Form and Instruction
Intro - Form 2000-222 - Self Contained Self Rescuer (SCSR) Inventory and Report.pdf www.msha.gov/support-resources/forms-online-filing/2015/04/15/self-contained-self-rescuer-scsr-inventory-and Instruction
MSHA Form 2000-222 SCSR Inventory & Report 2000-222.pdf www.msha.gov/support-resources/forms-online-filing/2015/04/15/self-contained-self-rescuer-scsr-inventory-and Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Emergency Mine Evacuation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 75.1714-8 30 CFR 75.1502(a) 30 CFR 75.1505 30 CFR 48.3(p) 30 CFR 75.1504 30 CFR 75.1714-3(e) 30 CFR 75.1714-4(d)(3) 30 CFR 75.1714-5

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MSHA Form 2000-222	SCSR Inventory & Report	2000-222.pdf	https://www.msha.gov/support-resources/forms-online-filing/2015/04/15/self-contained-self-rescuer-scsr-inventory-and	Yes	Yes	Fillable Fileable
Instruction			Intro - Form 2000-222 - Self Contained Self Rescuer (SCSR) Inventory and Report.pdf	https://www.msha.gov/support-resources/forms-online-filing/2015/04/15/self-contained-self-rescuer-scsr-inventory-and	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 208	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,035,909	-114,491	1,150,400
Annual IC Time Burden (Hours)	431,506	-47,776	479,282
Annual IC Cost Burden (Dollars)	52,298	-662	52,960

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.