Metalliferous Mines Regulations, 1961 - Directorate General of ...

(d) “Value” should be calculated upon actual or estimated selling price at the pit-head. Any charges
incurred in transporting the mineral outside the mine property should not be included. Royalty figures
will not be accepted.
(e) Each metal should be shown separately.
From :
…………………………………..
……………………………………
FIRST SCHEDULE
FORM IV-A
(See Regulation 9)
Notice of Accident/Occurrence
1. The Chief Inspector of Mines, …………..Dhanbd, E.Rly.
2. The Regional Inspector of Mines ………………………..
3. The District Magistrate/District Collector ………………
4. The Electric Inspectorof Mines (in case of electrical accidents only, Dhanbad).E .R. …….
Sir,
I have to furnish the following particulars of a fatal accident/a serious accident/a dangerous
occurrence (I) which occurred at the………………………………………… Mine (also state name of
mineral produced) of …………………………. (owner) :
1. PARTICULARS OF STHE MINE :
Situation of mine Mineral worked Name and postal address of owner
Village
Post office
Police station
Sub-Division (Taluq)
District
State
2. PARTICULARS OF THE ACCIDENT :
Date and hour of
accident /occurrence
Place and Location in mine
Number of persons(s)
Killed
Seriously injured
Classification of accident / occurrence(ii)
Its cause and description
3. PARTICULARSOF INJURIES ETC. :
Name of
person(s)(iii)
Killed
1
2
3
Injured
Nature of
employment
age sex Nature of injury and if fatal, cause
of death (iv)