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Form 5000-1 Disclaimer
(Certificate of Electrical/Noise Training)

This is a voluntary collection of information (30 C.F.R. Sec. 75.153 and 77.103). MSHA qualifies mine electricians and certifies persons to take noise level measurements in coal mines. MSHA form 5000-1 is used to report to MSHA those miners who have satisfactorily completed (1) a coal mine electrical program; or (2) a noise training course. Any personal information (e-mail or otherwise) submitted is used for contact purposes only. This personal information is not used or distributed to any other agency or used for any other purpose.