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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Mine Rescue Teams; Arrangements for Emergency Medical Assistance and Transportation for Injured Persons; Agreements; Reporting Requirements; Posting Requirements
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
30 CFR 49.4
30 CFR 49.3
30 CFR 49.2
30 CFR 49.5
30 CFR 49.6
30 CFR 49.7
30 CFR 49.8
30 CFR 49.9
30 CFR 49.12
30 CFR 49.13
30 CFR 49.16
30 CFR 49.17
30 CFR 49.18
30 CFR 49.19
30 CFR 49.50
30 CFR 75.1713-1
30 CFR 77.1702
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 2000-224
Operator’s Annual Certification of Mine Rescue Team Qualifications
2000-224_2 2020.pdf
http://arlweb.msha.gov/forms/elawsforms/2000-224.htm
Yes
Yes
Fillable Fileable
Instruction
INTRO Operator’s Annual Certification of Mine Rescue Teams Qualifications.pdf
http://arlweb.msha.gov/forms/elawsforms/2000-224.htm
Yes
Yes
Fillable Fileable
Instruction
INTRO Certificate of Physical Qualification for Mine Rescue Work.pdf
https://www.msha.gov/support-resources/forms-online-filing/2015/04/15/certificate-physical-qualification-mine-rescue-work
Yes
Yes
Fillable Fileable
Form
5000-3
Certificate of Physical Qualification for Mine Rescue Work
5000-3.pdf
https://www.msha.gov/sites/default/files/Support_Resources/Forms/5000-3.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Worker Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
577
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
55 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
40,588
0
19,973
20,215
0
400
Annual IC Time Burden (Hours)
13,107
0
9,941
3,163
0
3
Annual IC Cost Burden (Dollars)
1,980,169
0
309,068
1,671,001
0
100
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.