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

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

OMB: 1219-0127

IC ID: 14507

Documents and Forms

Document Name Document Type
Form MSHA Form 5000-41 Certification and Qualification to Examine, Test, Operate Hoists, and to Perform Other Duties Form
MSHA Form 5000-41 Safety and Health Activity Certification or Hoisting Engineers Qualification Request 5000-41_0.pdf www.msha.gov/support-resources/forms-online-filing/2018/05/23/health-activity-certification-or-hoisting-engineers Form
MSHA Form 5000-41 Safety and Health Activity Certification or Hoisting Engineers Qualification Request 5000-41_screenshots 11-2020.docx www.msha.gov/support-resources/forms-online-filing/2018/05/23/health-activity-certification-or-hoisting-engineers Form and Instruction
INTRO 5000-41.pdf www.msha.gov/support-resources/forms-online-filing/2018/05/23/health-activity-certification-or-hoisting-engineers Instruction