New Miner Training Record/certificate Template Page 3
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5NEW 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
th
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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