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  • APC 5000-23: MSHA Certificate of Training, 4-Part NCR
  • The APC 5000-23 MSHA Certificate of Training includes 25 4-part NCR sets,  and a thick, wrap-around cover to prevent unintentional NCR transfer.
  • APC 5000-23 MSHA Certificate of Training form.
  • Example of completed APC 5000-23 MSHA Certificate of Training form.
  • The APC 5000-23 MSHA Certificate of Training includes 25 4-part NCR sets,  and a thick, wrap-around cover to prevent unintentional NCR transfer. APC 5000-23 MSHA Certificate of Training form. Example of completed APC 5000-23 MSHA Certificate of Training form.

    APC 5000-23: MSHA Certificate of Training, 4-Part NCR

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    • Overview

    Product Description

    APC 5000-23 MSHA Certificate of Training book features 25, 4-part NCR carbon copy MSHA 5000-23 forms (100 pages total) and a wrap-around back flap to keep forms from transferring. Each MSHA form has 4 individual color parts: white - Employer's Personnel Record, pink - Employee's Record Copy, yellow - Employee's Separation Copy and green copy for Record Keeping.

    APC 5000-23 Form meets Mine Safety and Health Administration (MSHA) guidelines 30 CFR Part 48.9 & 48.29 for properly recording the training and retraining of underground miners, surface miners, construction workers and shaft & slope workers in the coal, metal and non-metal mining industries including: Training and Retraining of Miners Engaged in Shell Dredging or Employed at Sand, Gravel, Surface Stone, Surface Clay, Colloidal Phosphate, or Surface Limestone Mines as required by MSHA 30 CFR Part 46.9

    This is a mandatory collection of information as required by 30 CFR Part 48.9 and 48.29. The Certificate of Training Form 5000-23 provides a means for mine operators to record and certify Part 48 mandatory training received by miners. The training certificates for each miner shall be available at the operator mine site for inspection by MSHA and for examination by the miners, the miner's representative, and State inspection agencies. At the completion of training, the instructor MUST give the miner a copy of the training certificate. When a miner leaves the operator's employ, the miner shall be entitled to a copy of his training certificates.

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    IMPORTANT NOTICE: PLEASE READ

    The current MSHA Form 5000-23 has an expiration date of April 30, 2021 and the Approved OMB Number 1219-0009. Previously issued forms with an earlier expiration date with the approved OMB Number 1219-0009 may still be used according to MSHA. 

    Questions regarding this form should be directed to MSHA at https://www.msha.gov/ or (877)778-6055

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    APC 5000-23: MSHA Certificate of Training, 4-Part NCR

    2 Reviews Hide Reviews Show Reviews

    • 5
      5000-23

      Posted by Gary Osborne on 30th Jul 2019

      Professionaly made, priced right, quality material that is sent quickly!!

    • 5
      MSHA training Certificates

      Posted by Lloyd White on 26th Dec 2017

      Product was as expected. Exactly what we ordered.

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