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«Chapter 6 Chapter 6 HEALTH FORMS The following pages are forms that the inspector must use for health inspections or health investigative reports. ...»

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Coal Mine Health Inspection Procedures Handbook Chapter 6

Chapter 6


The following pages are forms that the inspector must use for health inspections or health

investigative reports. Other forms, such as the Mine Activity Data Form (2000-22), commonly

called the cover sheet, the Mine Status Data Form (2000-122), impoundment inspection forms, rock dust and air sample cards, are addressed in the General Inspection Procedures Handbook.

Form 2000-83 (Respirable Dust Laboratory Report)

Form 2000-84 (Environmental Noise Report)

Form 2000-86 (Appraisal of The Dust Control Plan)

Form 2000-87 (Inspector’s Review of Waiver Request)

Form 2000-88 (Waiver Request Action Underground)

Form 2000-90 (Waiver Request Action Surface)

Form 2000-95 (Mine Operator’s Respirable Dust Sampling Program Survey)

Form 2000-96 (Designated Occupation Change Notice)

Form 2000-142 (MMU/DA/DWP Data)

Form 2000-144 (Part 90 Miner Status)

Form 2000-187 (I.H. Inspection Data)

Form 2000-194 (I.H. Sampling Data)

Form 2000-198 (Diesel Equipment Inventory)

Dust Data Card

Request for Mining Health Hazard Evaluations (HHEs)

PH89-V-1 (February 1989) 6.1 Coal Mine Health Inspection Procedures Handbook Chapter 6


PH89-V-1 (February 1989) 6.2 Coal Mine Health Inspection Procedures Handbook Chapter 6 PH89-V-1 (February 1989) 6.3 Coal Mine Health Inspection Procedures Handbook Chapter 6


PH89-V-1 (February 1989) 6.4 Coal Mine Health Inspection Procedures Handbook Chapter6

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The purpose of this form is twofold; one, it will serve as a laboratory record of respirable dust samples collected and analyzed by MSHA, and two, it will be used by the health supervisors as an aid when evaluating the dust control plan. The form has been designated to be a complete record of all actions taken by MSHA laboratory technicians regarding respirable dust samples.

When’ completed, a copy of this form will be kept as the laboratory record, the original will be attached to Form 2000-86 (Appraisal of Dust Control Plan).

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C. Company Name - Name of the company as reported on the Legal Identity form.

D. MMU/DA/SA ID Number - The four-digit identification number assigned to a mechanized mining unit, designated area, or surface area by MSHA.

E. Average Production (last 30 prod. shifts) - Average production of a section in an underground mine. This does not apply to surface sampling.

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Concentration (Conc.) - Respirable dust concentration in MRE equivalent.

Average (Avg.) - Average dust concentration for each occupation.

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Totals – Cumulative totals of respirable dust concentrations. Cumulative totals of T.

samples collected. Not applicable to surface sampling.

U. Section Average - Average concentration of all samples collected on the section.

Not applicable to surface sampling.

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W. Reason for Void Samples - Indicate by cross reference any samples that are voided (K-1, P-4, S-6, etc.) and give an explanation or reason why the respirable dust samples were determined void.

X. O.S.P. Checked - List all samples that are checked for oversize particles by crossreference (K-1, P-4, S-6, etc.) Y. Date Lab Analysis Completed - Date that the respirable dust laboratory report is completed for the entire survey.

Z. Comments - Any comments that the lab technician or the inspector would like to make that are pertinent to the survey should be made in this space.

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MSHA’s noise data from surveys made during an inspection or investigation shall be recorded on Form 2000-84. This information shall be included with the cover sheet (2000-22) of the inspection or investigation report. On this form list the results of the noise surveys obtained by dosimeter or by sound level meter.

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P. Time Stop - Enter the 24-hour clock time when survey was completed.

Q. Time Start - Enter the 24-hour clock time when survey was begun.

–  –  –

W. Calibration/Check - Note here the appropriate calibration checks made before and after the noise survey.

X. Citation Number - Enter citation identification number if citation is issued.

Y. Comments - Self-explanatory. The date(s) of the instrument(s) and/or calibrator may be entered here showing the annual calibration check.

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PH89-V-1 (February 1989) 6.12 Coal Mine Health Inspection Procedures Handbook Chapter 6 PH89-V-1(22) (May 2009) Coal Mine Health Inspection Procedures Handbook Chapter 6

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FORM 2000-86 RESPIRABLE DUST SAMPLING AND MONITORING DATA This form is used to record the respirable dust control parameters that are observed and measured during inspection activities involving either the collection of respirable dust samples or the monitoring of the operator’s dust sampling program. This form should also be completed whenever the inspector believes that the approved plan parameters are not effective in maintaining dust concentrations at or below the applicable dust standard.

It is essential that the information/data recorded on MSHA Form 2000-86 accurately reflect the dust control measures and practices being used and the actual quantities measured, and is consistent with Chapter 1 – Respirable Dust as the completed form will serve as supporting documentation when plan changes are required and/or enforcement actions are taken.

The following instructions explain how to complete the form. Mine-specific information, or approved plan-specific information, may be completed in the office prior to the inspection.

1. Type of Inspection: This item contains three blocks. The inspector should check the appropriate block (s) to identify the type (s) of inspection activity being conducted.

Regular: If conducting dust sampling under an E01 inspection activity code, check the Regular block and complete items 1 through 25 and 28. If not sampling and the inspector believes that the parameters in the mine operator’s approved mine ventilation plan are not effective, complete items 1 through 7, 9 through 23, and 28.

Technical: If conducting other than a regular E01 inspection that involves collecting respirable dust samples, check the Technical block, note the inspection activity code, and complete items 1 through 25 and 28. If samples are not taken, complete item 1 through 7, 9 through 23, and 28.

Monitoring: If the inspection activity involves monitoring the operator’s respirable dust sampling program, check the Monitoring block and complete all items on the form.

NOTE: It is possible that more than one block could be checked depending on the type (s) of inspection activity conducted.

2. Date: The date the inspector actually conducted the evaluations.

3. Field Office Code: The five-digit identification number of the MSHA CMS&H office assigned the responsibility for inspecting the coal mine.

4. Mine I.D. - The seven-digit MSHA identification number assigned to the coal mine.

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7. MMU/DA/SA - The four-digit MSHA identification number assigned to the Mechanized Mining Unit (MMU), Designated Area (DA) or Surface Area (SA) that was evaluated.

–  –  –

8. Times Entity/Mine Cited for Excessive Dust Last 12 Months The number of excessive dust citations issued on the MMU/DA being evaluated, and the total number of excessive dust citations issued to the mine operator during the previous 12 month period.

9. AR Signature/AR Number - The signature of the inspector performing the evaluation and his/her five-digit identification number from the AR’s card of authorization (MSHA Form 1000-186).

10. Supervisor Signature - The signature of the supervisor assigned inspection responsibility for the affected mine after reviewing the form for completeness and accuracy.

11. Type of Mining System - Check the appropriate box that best describes the mining system in use: A. Longwall; B. Continuous; or C. Conventional. Also check each appropriate box under the type of system to more fully identify the type of equipment being used and the cut sequence.

NOTE: Under Conventional, the inspector should identify the type of system used to extract the coal, such as, scoop shooting-off-solid, cutting machine, etc.

12. Mining Ht - The total mining height in inches, and the total amount of rock being mined in inches.

13. Remote Operation of Miner - Check the appropriate block.

14. Type of Mining - Check the appropriate block. Note: Longwall mining systems that do not mine from previously driven entries are considered development.

15. Physical Conditions - Check the appropriate blocks.

16. Type of Haulage Equipment - This item applies only to continuous and conventional mining sections. Check the appropriate block to identify the type of haulage equipment that is being used to transport the coal from the face to the section dumping point.

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17. Roof Bolter Type - This item applies only to continuous and conventional mining sections. Check the appropriate block(s) to identify the type of roof bolting machine (s) used on the MMU and show the number of each type being used. A. Check the appropriate block to identify whether the roof bolting machine is being operated on a separate split of air from the Designated Occupation (DO), or working downwind of the DO. B. Check this block if there is a Designated Area (DA) established for the roof bolting machine operator. C. Check the block that describes the type of dust collecting system used on the roof bolting machine(s).

NOTE: If more than one roof bolting machine is operated on the MMU and the machines have different types of dust collecting system, the inspector should specify which machine has which type of dust collecting system.

Dust Control Parameters – Ventilation System - This is a six-part question that 18.

requires the inspector to record what was actually observed and/or measured at the time of the evaluation.

A. Method of Face Ventilation: Check the appropriate block(s) to show the type of ventilation used. If Both is checked, briefly explain the circumstances under Item 28.

B. Face Ventilation Devices: Check the appropriate block(s).

C. Line Curtain/Tubing Distance: Enter the maximum observed distance in feet that the ventilation device (s) is located from the area of deepest point of penetration to which any portion of the face has been advanced.

D. Is Face Area Ventilated with Belt Air? Check the appropriate block.

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F. Air Quantity: Fill in the information for the type of mining system being used. This is a two-part question. Each part requires the inspector to enter both the approved plan minimum requirements and the actual quantities and velocities that were measured at the time of the evaluation for each of the listed control parameters. The recorded scrubber operational cfm must be the result of an actual full pitot tube traverse as determined in accordance with Chapter 1 or a correlated centerline measurement. Also, identify whether the readings were obtained during the 1st or 2nd half of the shift.

Dust Control Parameters – Water Spray System - This is a three-part question.


The first part requires the inspector to enter both the approved minimum plan requirements and what was actually observed in use and/or measured at the time of the inspection. When determining the operating water spray pressure, remove the spray nozzle and place the pressure gauge in the spray hole using a tee fitting and then place the spray nozzle in the tee to obtain an accurate reading. The second and third parts are self-explanatory and require the inspector to check the appropriate blocks.

PH89-V-1 (22) (May 2009) 6.14b

Coal Mine Health Inspection Procedures Handbook Chapter 6

20. Auxiliary Controls - Enter the appropriate information about the auxiliary dust controls or work practices observed in use at the time of the inspection, even if these controls are not listed in the approved mine ventilation plan.

For example, this may include the use of additional ventilation controls to divert the dust away from the miners; use of wetting agents; additional wetting of the coal prior to mining; the frequency of wetting down roadways; administrative controls such as limiting the amount of time roof bolter operators or others work downwind of the mining machine; the frequency the roof bolter operator cleans the dust box; and where the fines from the dust box are deposited.

The dust control measures and work practices that are in use but are not listed in the approved plan may be critical in determining if the miners are adequately protected during normal mining operations. If these measures are being used only when dust sampling is occurring, it is likely that miners may be exposed to higher dust concentrations during normal mining operations. Inspectors should ask a representative number of miners if these control measures are in use all the time. If not, the inspector should make note of this in Item 28.

21. Are Approved Respirators being Worn? - Check the appropriate block. If miners are observed wearing respirators, the inspector should identify which miners are wearing respirators and the make and model of the device being worn. Additionally, the inspector should determine if the affected miners have been fit-tested and trained in the proper use and maintenance of the respirators.

22. Do Miners Work Downwind of the Longwall Shearer? - Check the appropriate block that most accurately describes the amount of time miner (s) was observed working downwind of the shearer at the time of the inspection.

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