New Miner Training Record/Certificate Form Download Fillable PDF

NEW MINER TRAINING RECORD/CERTIFICATE

Miner’s Full Name (Print)

Mine or Contractor Name

ID#

Subject

Course

Date

Competent

Location

Miner’s

(Name &

30 CFR Part 46.5

Length

Person

Initials

Address if Institution)

The miner received no less than 4 hours training in the following, before beginning work:

(b) (1) Introduction to work

environment, mine tour, mining

method/operation

(b)(2) Instruction on recognition and

avoidance of electrical and other hazards

(b)(3) Emergency procedures, escape,

and firefighting

(b)(4) Health and safety aspects of tasks

assigned

(b)(5) Instruction on statutory rights of

miners and their representatives

(b)(6) Authority & responsibility of

supervisors and miners’ representatives

(b)(7) Introduction to your rules and

procedures for reporting hazards

No later than 60 days:

(c)(1) Self-rescue, respiratory devices, if

used

(c)(2) First aid

No later than 90 days (balance of 24 hours including the following subjects):

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act

I certify that the above training has been completed

(Signature of person responsible for health and safety training)

(Date)

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NEW MINER TRAINING RECORD/CERTIFICATE

Miner’s Full Name (Print)

Mine or Contractor Name

ID#

Subject

Course

Date

Competent

Location

Miner’s

(Name &

30 CFR Part 46.5

Length

Person

Initials

Address if Institution)

The miner received no less than 4 hours training in the following, before beginning work:

(b) (1) Introduction to work

environment, mine tour, mining

method/operation

(b)(2) Instruction on recognition and

avoidance of electrical and other hazards

(b)(3) Emergency procedures, escape,

and firefighting

(b)(4) Health and safety aspects of tasks

assigned

(b)(5) Instruction on statutory rights of

miners and their representatives

(b)(6) Authority & responsibility of

supervisors and miners’ representatives

(b)(7) Introduction to your rules and

procedures for reporting hazards

No later than 60 days:

(c)(1) Self-rescue, respiratory devices, if

used

(c)(2) First aid

No later than 90 days (balance of 24 hours including the following subjects):

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act

I certify that the above training has been completed

(Signature of person responsible for health and safety training)

(Date)

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NEWLY-HIRED EXPERIENCED MINER TRAINING RECORD/CERTIFICATE

Miner’s Full Name (Print)

Mine or Contractor Name

ID#

Subject

Course

Date

Competent

Location

Miner’s

(Name & Address if

30 CFR Part 46.6

Length

Person

Initials

Institution)

The miner has received the following training before beginning work:

(b)(1) Introduction to work

environment, mine tour, mining

method/operation

(b)(2) Instruction on recognition and

avoidance of electrical and other

hazards

(b)(3) Emergency procedures, escape,

and firefighting

(b)(4) Health and safety aspects of

tasks assigned

(b)(5) Instruction on statutory rights of

miners and their representatives

(b)(6) Authority & responsibility of

supervisors and miners’ representatives

(b)(7) Introduction to your rules and

procedures for reporting hazards

No later than 60 days:

used

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act

I certify that the above training has been completed

(Signature of person responsible for health and safety training)

(Date)

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NEW TASK TRAINING RECORD/CERTIFICATE

Miner’s Full Name (Print)

Mine or Contractor Name

ID#

New Task

Subject

Date

Competent

Location

Miner’s

30 CFR Part 46.7

Length

Person

Initials

(Name & Address of Institution)

The miner received

e following training before performing a new task, or a change occurred in an assigned task that affects health and

safety risk:

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act

I certify that the above training has been completed

(Signature of person responsible for health and safety training)

(Date)

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ANNUAL REFRESHER TRAINING RECORD/CERTIFICATE

Miner’s Full Name (Print)

Mine or Contractor Name

ID#

Subject

Date

Competent

Location

Miner’s

(Name & Address if

30 CFR Part 46.8

Length

Person

Initials

Institution)

The miner received no less than 8 hours of annual refresher training in the following:

Instruction on changes at the

mine that could adversely

affect the miner’s health or

safety

Health and safety subjects

relevant to mining operations

at the mine

(For recommended subjects see 46.8 (c))

xxxxxxxxxxxxxxxxx

xxxxxx

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act

I certify that the above training has been completed

(Signature of person responsible for health and safety training)

(Date)

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SITE-SPECIFIC HAZARD AWARENESS TRAINING

RECORD/CERTIFICATE

Miner’s Full Name (Print)

Mine or Contractor Name

ID#

Location:

Mine Site

Length of Training:

Date Training Provided:

Competent Person Providing

the Training:

Miner’s Initials:

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act

I certify that the above training has been completed

(Signature of person responsible for health and safety training )

(Date)

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"New Miner Training Record/Certificate Form"

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