West Virginia Office of Miners' Health Safety and Training

Underground and Surface Mine

Certificate of Approval Extension Applications
Last revised:  04/23/14 02:01 PM

Please read carefully the instructions and if you have questions, contact one of our offices or use the contact link below to email your questions.

This year,  the Office of Miners' Health, Safety and Training is providing PDF forms for extensions - these are forms with fields that you can complete. You will need a current version of the Adobe Reader (see the link below) in order to complete the application. The Application and General Information forms have been combined into one PDF Document.

1. Click on the link for the Application and Extension Package (below).

2. Complete the form; note certain sections of the form have questions  for Underground Operations, some questions are specifically for Surface mines and other questions for both types of operations. You can ignore the questions relating to quarries and coal handling facilities. Your WVMHS&T Permit Number is critical for your applications to be processed properly. Not sure of your permit number? View a list of all current  permits here: WV Permits Listings
Verify your Permit Number before you enter data!

3. Once the form is complete you will need to print it out (you can save a copy to your hard drive if you want a digital copy). There is a "print this form" button at the bottom of the last page.

4. The completed form must be signed and dated by a company official.  We must have a legal signature of a company official on the form.

5. The completed form may be mailed or faxed to your WVMHST Regional Office.  The address and fax numbers are on the Application.  You have the option to email the completed PDF form if you have a digital signature, or you can scan the signed document and send it as an email attachment to your WVMHST Regional Office. (see the Regional Email addresses below)

6. Your permit fee of $100 may be paid on-line Use this link to pay your Extension fee

7. Assessments may also be paid on-line Use this link to Pay Penalty Assessments

Download the current version of  Acrobat Reader  adobe button 


Underground & Surface Mine Certificate of Approval Extension Application Package
(Fillable Forms)----
you must print after you complete unless you have the adobe version that allows you to save changes

Non fill-able Version of the Extension Application Package

Regional Email Links (send your completed application)

Region 1- Westover,   Region 2- Welch,

 Region 3 - Danville,     Region 4 - Oak Hill

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