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1(*PA <br />Employee Training Attendance Roster <br />Facility Name:_yr07�r_ <br />HAZARD COMMUNICATION & EMERGENCY RESPSE <br />READ THE FOLL0W7NG BE FG SIGNING <br />I acknowledge that I have received Hazard Communication Training. During this training I was made generally aware of hazards <br />associated with chemicals present at the facility, steps I can take to reduce these hazards, and typical responses in the event of an <br />emergency. I was also made aware of chemical specific information available to me in the form of product labels and Safety Data <br />Sheets (SDS). I was made aware of the Global Harmonization Standard (GHS) changes to the HAZCDM standard. Changes that <br />Include: Hazard Classification, labeling requirements, and SDS formatting. I understand that I may review the facilities Hazard <br />Communication Program and SDSs any time during my work shift. <br />I also acknowledge that I have received Emergency Response Training, During this training I was made aware of guidelines for <br />responding to a fire or explosion (including use of portable hand-held fire extinguishers), a release of hazardous materials, and certain <br />natural disasters. [ was also informed of the facilities evacuation assembly point. <br />1 understand that the facility alone Is responsible for environmental and safety issues at the facility, and that I should contact my <br />supervisor with any questions or concerns that I have about these matters. <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />S <br />9 <br />10 <br />11 <br />12 <br />1.3 <br />14 <br />15 <br />16 <br />17 <br />18 <br />19 <br />20 <br />21 <br />22 <br />23 <br />Printed Name Job Description - Signature <br />I ceruTy in at l conouctea kmergency Response i raining In accordang,, MM Federal & State requirements with the above listed employees, <br />KPA Consultant (Printed Name) Signature pate <br />