Information Collection

Emergency Mine Evacuation

IC 14531 under ICR 202507-1219-001 · OMB 1219-0141.

Documents and Forms

Document Name Document Type
Form MSHA Form 2000-222 Emergency Mine Evacuation Form and Instruction
Form MSHA Form 2000-222 SCSR Inventory & Report Emergency Mine Evacuation Form and Instruction
Intro - Form 2000-222 - Self Contained Self Rescuer (SCSR) Inventory and Report.pdf www.msha.gov/support-resources/forms-online-filing/2015/04/15/self-contained-self-rescuer-scsr-inventory-and Instruction
Intro - Form 2000-222 - Self Contained Self Rescuer (SCSR) Inventory and Report.pdf www.msha.gov/support-resources/forms-online-filing/2015/04/15/self-contained-self-rescuer-scsr-inventory-and Instruction
MSHA Form 2000-222 SCSR Inventory & Report MSHA_2000-222.pdf www.msha.gov/support-resources/forms-online-filing/2015/04/15/self-contained-self-rescuer-scsr-inventory-and Form and Instruction
MSHA Form 2000-222 SCSR Inventory & Report MSHA_2000-222.pdf www.msha.gov/support-resources/forms-online-filing/2015/04/15/self-contained-self-rescuer-scsr-inventory-and Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Emergency Mine Evacuation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 75.1714-4(d)(3) 30 CFR 75.1714-8 30 CFR 75.1714-5 30 CFR 75.1502(a) 30 CFR 75.1505 30 CFR 75.1714-3(e) 30 CFR 48.3(p) 30 CFR 75.1504

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MSHA Form 2000-222	SCSR Inventory & Report	MSHA_2000-222.pdf	https://www.msha.gov/support-resources/forms-online-filing/2015/04/15/self-contained-self-rescuer-scsr-inventory-and	Yes	Yes	Fillable Fileable
Instruction			Intro - Form 2000-222 - Self Contained Self Rescuer (SCSR) Inventory and Report.pdf	https://www.msha.gov/support-resources/forms-online-filing/2015/04/15/self-contained-self-rescuer-scsr-inventory-and	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	979,804	112,466	867,338
Annual IC Time Burden (Hours)	422,930	50,169	372,761
Annual IC Cost Burden (Dollars)	37,352	-24,834	62,186

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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