How to Fill Out Annual Refresher Training Record/Certificate

Annual Refresher Training Record/Certificate at a glance

What it is: Annual Refresher Training Record/Certificate: the miner received no less than 8 hours of annual refresher training.

Who signs: The person responsible for health and safety training signs.

A filled-in Annual Refresher Training Record/Certificate example: a trainer records two subjects for a miner

Annual Refresher Training Record/Certificate example filled out, example: a trainer records two subjects for a miner
A mine trainer fills out the annual refresher record for miner Dana Sample. Dana took 2 hours on mine changes and 6 hours on one other subject. The picture shows the first two subject lines, and all its values are invented.

How to fill out Annual Refresher Training Record/Certificate, box by box

Miner and mine

Annual Refresher Training Record/Certificate example filled out, miner and mine

Print the Miner's Full Name.

Enter the Mine or Contractor Name and the ID#.

Instruction on changes at the mine

Annual Refresher Training Record/Certificate example filled out, instruction on changes at the mine

For Instruction on changes at the mine that could adversely affect the miner's health or safety, enter the Course Length, Date, Competent Person, Location (Name & Address if Institution) and Miner's Initials.

For each of the other subjects too, enter the Course Length, Date, Competent Person, Location (Name & Address if Institution) and Miner's Initials.

Other health and safety subjects

Annual Refresher Training Record/Certificate example filled out, other health and safety subjects

Enter each other Health and safety subject relevant to mining operations at the mine (for recommended subjects see 46.8(c)).

Certification and date

Annual Refresher Training Record/Certificate example filled out, certification and date

False certification is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act. By signing you certify that the training has been completed: Signature of person responsible for health and safety training.

Enter the Date.

Sources

[1] MSHA Part 46 Annual Refresher Training Record/Certificate, U.S. Department of Labor Mine Safety and Health Administration (the Official source link on this page).

Training Record Certificate Form PDF Details

In the realm of mining operations, the significance of rigorous training to ensure the health and safety of miners is paramount. A critical part of this training regimen is encapsulated through the Annual Refresher Training Record/Certificate form. This document serves not only as proof of completion but also as a detailed account of the training each miner has undergone within a given year. It includes essential information such as the miner's full name, the name of the mine or contractor, and a unique identification number. Furthermore, it specifies the subject matter covered under 30 CFR Part 46.8, ranging from instructions on changes at the mine that could impact the miner’s health or safety to health and safety subjects relevant to mining operations. The form meticulously records the length of each subject, the date of training, the name and address of the institution where it took place (if applicable), and the competent person who conducted the training. Miners acknowledge the training received with their initials, ensuring accountability and the veracity of the information recorded. Importantly, the form underscores the legal ramifications of false certification, which is punishable under section 110 (a) and (f) of the Federal Mine Safety and Health Act, thus emphasizing the critical nature of honesty and accuracy in these records. The concluding section of the form requires the signature of the person responsible for health and safety training at the mine, alongside the date, thereby finalizing the certification process. This document not only formalizes the completion of vital safety training but also represents a key component in the broader framework of safety regulations and practices essential to the mining industry.

QuestionAnswer
Form NameTraining Record Certificate Form
Form Length1 page
Fillable?Yes
Fillable fields105
Avg. time to fill out15 sec
Other namesmsha annual refresher form, training refresher annual, refresher certification, 30 cfr 46 8