West Virginia Office of Miners' Health Safety and Training
Certification Applications, Permit Applications, Forms and Documents
Which WV MHST form do you need?
Select from the links below. For example, if you need a surface foreman application click on the Miner Certification link, if you need a General Information form for an underground mine, click on the Mine Permit Applications link.
OUR WELCH OFFICE ADDRESS HAS
CHANGED PLEASE NOTE THE NEW ADDRESS: 830
Virginia Avenue, Welch, WV 25901
(we are attempting to update all forms with the new address; the new address was effective DECEMBER, 2017)
WV OFFICE OF MHST
NUMBER 7 PLAYERS CLUB DR. - SUITE 2
CHARLESTON, WV 25311-1626
Miner Certification - All Certification Types Including Foreman
Safety Sensitive Personnel List Form
Safety Sensitive Personnel Document Form
80 and 40 Hour Instructor Application and Update Form WORD (PDF)
Continuing Education of Underground Mine Foreman Instructor and Update Form (word)
and Instructor Applications
Inspector and Instructor Job
Description and Qualifications
Mine and Surface Mine Permit Applications
Contractor Certificate of Approval and Renewal Applications
Reporting Forms Page Click on links below to go directly to PDF forms for:
*SOME VERSIONS OF ADOBE ACROBAT WILL HAVE THE OPTION FOR YOU TO SAVE FILLABLE PDF FORMS. IF YOU DON'T HAVE THE VERSION THAT ALLOWS YOU TO SAVE; YOU CAN STILL USE THE FORMS. SIMPLY COMPLETE THE FORM AND PRINT IT.
10. Agency Administration Forms
REVISED Diesel Forms and Plans
12. EMT-M and EMT-M Instructor Class Roster and Application
EMT-M Instructors PLEASE SEE PUBLICATIONS
13. Metatarsal Boot Waiver application
This privacy notice discloses the privacy practices for the West Virginia Office of Miners’ Health Safety and Training.
This privacy notice applies solely to information collected by this agency.
Our forms require Acrobat Reader to view and download. To download a free version of the current Acrobat Reader, follow the link above.
MHS&T Homepage Publications Page Frequently Asked Questions Miner Certification Forms Mine Forms Independent Contractor Forms
Note: The information obtained from these documents is accurate to the best of our knowledge and is not a substitute for current mining laws or regulations. The state is not liable for any damages resulting from any information that unintentionally may be inaccurate or untimely.
If you don't find the form you need, or if you have accessibility issues with our forms, please contact us by email (see the link below) and we will assist you. We have attempted to make our forms accessible as required by state and federal regulations.
©2004 West Virginia
Office of Miners' Health Safety and Training.
An official West Virginia State Agency Web site.
Read our Privacy Notice Summary. Contact us.
Date this page was last updated: 01/03/2019