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Pool U.S. Department of Labor Preliminary Report of Accident 04Sep12 3. Date/Time of Accident 2. Accident Classification 1. Accident Type: Fatal Injury Mine Safety and Health Administration Slip or
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How to fill out MSHA - Preliminary Report:

01
Start by gathering all the necessary information such as the name of the mine, date of the incident, and the names of all individuals involved.
02
Provide a detailed description of the incident, including the location, time, and any specific machinery or equipment involved.
03
Include information about any injuries or fatalities that occurred as a result of the incident.
04
List out the potential causes of the incident, such as equipment failure, improper training, or hazardous conditions.
05
Describe any corrective actions that have been taken or will be taken to prevent similar incidents in the future.
06
Include any additional documentation or evidence, such as photographs or witness statements, to support your report.
07
Ensure that the report is accurate, complete, and legible. Double-check all information before submitting.

Who needs MSHA - Preliminary Report?

01
Mining companies and operators who are required to comply with the Mine Safety and Health Administration (MSHA) regulations.
02
Mine owners, supervisors, and safety personnel who are responsible for the overall safety and well-being of the mine and its workers.
03
MSHA inspectors and officials who review and investigate incidents to improve safety standards and enforce regulations.
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MSHA - preliminary report is a report required by the Mine Safety and Health Administration (MSHA) that provides preliminary information about accidents, injuries, and illnesses at mining operations.
Mining operators are required to file MSHA - preliminary reports.
MSHA - preliminary reports can be filled out online using the MSHA's electronic filing system or by submitting a paper form.
The purpose of MSHA - preliminary report is to gather initial information about accidents, injuries, and illnesses in order to identify trends and improve safety in the mining industry.
Information such as the date, time, location, and nature of the incident, as well as details about the individuals involved and the response taken, must be reported on the MSHA - preliminary report.
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