(a) This section shall be completed for all accidents immediately reported to MSHA as defined in § 50.10. Circle the code from the following list which best defines the accident:

Code 01—A death of an individual at a mine; Code 02—An injury to an individual at a mine which has a reasonable potential to cause death; Code 03—An entrapment of an individual for more than 30 minutes; Code 04—An unplanned mine inundation by a liquid or gas; Code 05—An unplanned ignition or explosion of dust or gas; Code 06—An unplanned mine fire not extinguished within 30 minutes of discovery; Code 07—An unplanned ignition of a blasting agent or an explosive; Code 08—An unplanned roof fall at or above the anchorage zone in active workings where roof bolts are in use; or a roof or rib fall on active workings that impairs ventilation or impedes passage; Code 09—A coal or rock outburst that causes withdrawal of miners or which disrupts regular mining activity for more than one hour; Code 10—An unstable condition at an impoundment, refuse pile, or culm bank which requires emergency action in order to prevent failure, or which causes individuals to evacuate an area; or, failure of an impoundment, refuse pile, or culm bank; Code 11—Damage to hoisting equipment in a shaft or slope which endangers an individual or which interferes with use of the equipment for more than thirty minutes; and Code 12—An event at a mine which causes death or bodily injury to an individual not at the mine at the time the event occurs.