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Get DoL Annual Refresher Training Record/Certificate

ANNUAL REFRESHER TRAINING RECORD/CERTIFICATE Miner s Full Name Print ID Mine or Contractor Name Subject 30 CFR Part 46. 8 Length Date Competent Person Location Name Address if Institution Miner s Initials 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 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 Print This Form Clear Page.

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