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​​​​​Mining Certification Forms​​​

Click on the links below to access the documents you need.  Make sure to follow the directions on completing each document accurately:   

Drug Test Reporting DTR-1

Notification of an Occupational Injury EB-83

Mine License EB-4

Private Instructor Notification of Training

Surface and Underground Foreman, Surface and Underground Instructor, Assistant Foreman and Inspector  Personal Data Sheet and Affidavit

Blaster Solid Conventional Affidavit  Affidavit - Solid Blasting

Electrical Affidavit Electrical Affidavit

Hoist Engineer Personal Data Sheet and Affidavit

MET Training EF-16 MET Retraining

MET Application for Initial Training EF-18 MET Initial 40-hour Course EF-18

Application for Miner Certification EG-47 Application for Miner Certification EG-47

Certified EMT or certified EMT instructors who are exempted from challenging the MET examination​ Application for MET Certification EF-17

Class Enrollment Form for Private and Contract Instructors EF-6A​ Class Enrollment 

MSHA Form 5000-23 MSHA Form 5000-23​

Kentucky Energy and Environment Cabinet
300 Sower Blvd
Frankfort, KY 40601

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The Kentucky Energy and Environment Cabinet does not discriminate against any person on the basis of race, color, national origin, religion, age, disability or sex. This policy protects the rights of Cabinet employees, service applicants and customers. Vendors, agencies and organizations providing services to the Cabinet or its recipients of federally-aided programs also must comply with this policy.