Form MSHA-NA Mine Operator Coal Dust Operator Data Card

Respirable Coal Mine Dust Sampling

Front_and_Back_of_Dust_Data_card

Respirable Coal Mine Dust Sampling

OMB: 1219-0011

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1219-0011 can be found here:

2024-05-29 - No material or nonsubstantive change to a currently approved collection

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Inspector Form

Operator Form

File Type	application/pdf
File Modified	2012-05-17
File Created	2012-05-17

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