Respirable Coal Mine Dust Sampling

U.S. DEPARTMENT OF LABOR

Mine Safety and Health Administration

Electronic Mine Operator Dust
Data Card
Form ID: N/A
Description
30 CFR Sections 70.210(a) and (c) and 71.207(a) and (c) require each Coal Mine Dust Personal

Sampler Unit (CMDPSU) sample to be transmitted to MSHA with a completed Dust Data Card. 
MSHA requires a Dust Data Card for every CMDPSU sample. 
Control ID: 1219-0011
Expiration Date: Fri, 10/31/2025 - 12:45
Contact Information
Questions regarding this form should be directed to MSHA at (877) 778-6055 or

desk.help@dol.gov.
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Legal Authority
30 CFR Sections 70.210(a) and (c) and 71.207(a) and (c)
Burden Statement
Public reporting burden for this form is estimated to average 7 minutes per response. The

burden estimate includes the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and submitting the form. This
collection of information is mandatory and will be retained for 1 year.  You are not required to
respond to this collection of information unless it displays a valid OMB control number. Send
comments regarding the accuracy of the burden estimate and any suggestions for reducing the
burden to: to the Mine Safety and Health Administration, U.S. Department of Labor, Office of
Standards Regulations and Variances, 201 12th Street South, Suite 401 Arlington, VA 22202-5450,

Paperwork Reduction Project (1219- 0011). NOTE: Do not send your completed form to this
address.
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Electronic Mine Operator Dust Data Card

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