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Electronic Mine Operator Dust Data Card

Form ID

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
Expiration Date
Fri, 10/31/2025 - 12:45
Contact Information

Questions regarding this form should be directed to MSHA at (877) 778-6055 or

Privacy Notice
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.