Metalliferous Mines Regulations, 1961 - Directorate General of ...
Metalliferous Mines Regulations, 1961 - Directorate General of ... Metalliferous Mines Regulations, 1961 - Directorate General of ...
1. General : (i) Name of mine …………………………….. (ii) Mineral produced ………………………… (iii) Owner ……………………………………. (iv) District ……………….(v) State ………… 2. Name of Injured Worker ……………………………. 3. Time of Accident : (i) Date …………………(ii) Time ………… ……..(iii) Shift …………………… (iv)Number of shifts worked per day at the mine ……………………. (v) Time when the worker began work on the day f the accident…………… 4. Occupation and Experience of the Worker : (i) State the nature of job he was doing at the time of accident…………… (ii) Was it his regular occupation ? …………………….. (a) If yes, state length of experience at the occupation : At your mine ……………………. Previous experience , if any ……………….. (b) If no, state how long employed at this job……………………………. (iii) State total experience in mining , coal and metalliferous ………………… (iv) Give details of experience in mining work …………………………….. 5. Place of accident : (i) if belowground, state : (a) Whether development area or depillaring/stoping area………………… (b) Number or Name of Seam/Vein……………………………………….. (c) Dimensions at the place of accident ………………………………….. (ii) If on surface, state whether on railway, tramway, power plant or elsewhere (to be specified)…. (iii) If other, state whether open-workings, shaft or elsewhere (to be specified) …………… 6. Nature of Injury : (i) State whether fracture, amputation, laceration, bruise, sprain, crushing injury or other (to be specified)………….. (ii) Part of body injured (to be specified precisely) …………….. 7. Degree of Disability : (i) if fatal, date and time of expiry ……………….. (ii) If permanent disablement, specify :- (a) the part or parts of the body lost, if any ………………… (b) the part or parts of body gone out of use …………………. (c) Whether disablement, was total or partial ……………….. (iii) If temporary disablement, state number of days forced to remain idle ………………… 8. Responsibility for the Accident : (i) (ii) (iii) (iv) (v) Was any safety provision(s) contravened ? ………………….. If so, by whom ? ……………………………………………… What action was taken against the offender ? ………………. Could the accident have been avoided ? ……………………. If so, how ? ………………………………………………….. Signature ………………………… Designation : Owner/Agent/Manager
Date ……………………………….. FIRST SCHEDULE FORM IV-C (See Regulation 9) Particulars of Injured person returned to duty (To be given separately in respect of every person within 15 days of his return to duty ) 1. General : (i) Name of mine …………………………….. (ii) Mineral produced ………………………… (iii) Owner ……………………………………. (iv) District ……………… .(v) State ………… 2. Name of Injured Worker ……………………………. 3. Return to duty : (i) Date when returned to work …………………….. (ii) Whether rturned to regular job or some other job (to be specified) …………….. 4. Compensation : State amount of compensation paid, or to be paid, if any ……………………….. Signature ………………………… Designation : Owner/Agent/Manager Date ……………………………….. From : ………………………………….. …………………………………… FIRST SCHEDULE FORM V (See Regulation 10) Notice of Disease notified under section 25 1. The Chief Inspector of Mines, …………..Dhanbd, E.Rly. 2. The Regional Inspector of Mines ……………………….. 3. The Inspector of Mines (in case of electrical accidents only, Dhanbad).E .R. ……. 4. The District Magistrate/District Collector ……………… Sir,
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1. <strong>General</strong> :<br />
(i) Name <strong>of</strong> mine ……………………………..<br />
(ii) Mineral produced …………………………<br />
(iii) Owner …………………………………….<br />
(iv) District ……………….(v) State …………<br />
2. Name <strong>of</strong> Injured Worker …………………………….<br />
3. Time <strong>of</strong> Accident :<br />
(i) Date …………………(ii) Time ………… ……..(iii) Shift ……………………<br />
(iv)Number <strong>of</strong> shifts worked per day at the mine …………………….<br />
(v) Time when the worker began work on the day f the accident……………<br />
4. Occupation and Experience <strong>of</strong> the Worker :<br />
(i) State the nature <strong>of</strong> job he was doing at the time <strong>of</strong> accident……………<br />
(ii) Was it his regular occupation ? ……………………..<br />
(a) If yes, state length <strong>of</strong> experience at the occupation :<br />
At your mine …………………….<br />
Previous experience , if any ………………..<br />
(b) If no, state how long employed at this job…………………………….<br />
(iii) State total experience in mining , coal and metalliferous …………………<br />
(iv) Give details <strong>of</strong> experience in mining work ……………………………..<br />
5. Place <strong>of</strong> accident :<br />
(i) if belowground, state :<br />
(a) Whether development area or depillaring/stoping area…………………<br />
(b) Number or Name <strong>of</strong> Seam/Vein………………………………………..<br />
(c) Dimensions at the place <strong>of</strong> accident …………………………………..<br />
(ii) If on surface, state whether on railway, tramway, power plant or elsewhere (to be<br />
specified)….<br />
(iii) If other, state whether open-workings, shaft or elsewhere (to be specified) ……………<br />
6. Nature <strong>of</strong> Injury :<br />
(i) State whether fracture, amputation, laceration, bruise, sprain, crushing injury or other (to be<br />
specified)…………..<br />
(ii) Part <strong>of</strong> body injured (to be specified precisely) ……………..<br />
7. Degree <strong>of</strong> Disability :<br />
(i) if fatal, date and time <strong>of</strong> expiry ………………..<br />
(ii) If permanent disablement, specify :-<br />
(a) the part or parts <strong>of</strong> the body lost, if any …………………<br />
(b) the part or parts <strong>of</strong> body gone out <strong>of</strong> use ………………….<br />
(c) Whether disablement, was total or partial ………………..<br />
(iii) If temporary disablement, state number <strong>of</strong> days forced to remain idle …………………<br />
8. Responsibility for the Accident :<br />
(i)<br />
(ii)<br />
(iii)<br />
(iv)<br />
(v)<br />
Was any safety provision(s) contravened ? …………………..<br />
If so, by whom ? ………………………………………………<br />
What action was taken against the <strong>of</strong>fender ? ……………….<br />
Could the accident have been avoided ? …………………….<br />
If so, how ? …………………………………………………..<br />
Signature …………………………<br />
Designation : Owner/Agent/Manager
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