5000 23 pdf-2026

1. Click ‘Get Form’ to open the 5000 23 pdf in the editor.
2. Begin by entering the full name of the person trained in the designated field. Ensure accuracy as this is a critical component of the certification.
3. Select the type of approved training received by checking the appropriate box. Options include Annual, Experienced Miner, Refresher, Newly Employed, New Task, and Inexperienced Miner.
4. Indicate the type of operation and related industry by checking one or more boxes that apply, such as Surface, Underground, Coal, Metal, or Nonmetal.
5. Fill in the date when training requirements were completed. If not completed, check the corresponding box and proceed to item 5.
6. If applicable, check off subjects completed for partially completed training. This includes various safety topics relevant to mining operations.
7. Ensure that both responsible parties sign where indicated: one for training completion and another for verification of training received.
8. Finally, enter the mine name, ID, and location of training before saving your document.

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