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UNIVERSITY OF THE PACIFICI Risk Management Training Form <br /> STOCKTON CA <br /> Subject: CHP,TIPP;HMMP,lab safety,WPV and related topics <br /> presenter.Ash Chaudhry Date: August 30, 2011 Time in training: ...60.... min <br /> PLEASE PRINT NAME SIGNATURE JOB TITLE DEPT <br /> Do Researcher o TA o Professo�aAdmin oBio,V Chan n PHS <br /> U a� �lcCa n ��� <br /> 2 ' o Researcher)(TA a Professor c Admin oBio XCtem o PHS <br /> 1101-16- Sect IQIII-Rvri��CA <br /> 3 o Researcher VQTA o Professor cAdmin oBio glChem o PHS <br /> 4 �i -S(n �q; lite J <br /> AReseercher o TA o Professor oAdmin oBio Ahoul c PHS <br /> 5 o Researcher in TAJ4 Professor oAdmin oBio o Chem o PHS <br /> R w► <br /> 6 v o Researcher a TA)(Professor eAdmin oBio Chem o PHS <br /> ( IQ WQ <br /> o Researcher o TA Professor oAdmin oBio HS <br /> Tem ❑P <br /> L1 �� <br /> S o Researcher'gTA o Professor oAdmm 'XBio n Chem o PHS <br /> A r <br /> y ❑Researcher &TA❑Professor oAdmin eSto o Chem o PHS <br /> fUUY'a y2, 0.G(ta <br /> 10 .� o Researcher ATA a Professor eAdmin m o Chem o PHS <br /> OMMI JRV AaHAryKItIZ JtM }�� i-1 <br /> 11 ChY\ o Researcher ILTA o Professor nAdmin io o Chem a PHS <br /> St1Y1Q, KO �/� 0 U �..�/ <br /> 12 o Researcher u TA o Professor oAdmin oBio Chan o PHS <br /> arbir �I/�fli�Q <br /> 13 o Researcher)(TA o Professor nAdmin )tNo o Chem o PHS <br /> � b <br /> 14Osltss4 SvirA NA S'� � ,.,n-- <br /> u Researcher *TA n Professor uAdmin )gBio o Chem o PHS <br /> ��,'. <br /> 15 o Researcher,IrfTA o Professor oAdmm ,01]lio o Chem o PHS <br /> ,n <br /> 16 o Researcher tgA in Professor oAdmin Wo o Chem o pHs <br /> OY1 Y1i..� <br /> 17 RV <br /> s - / o Researcher)d TA o Professor nAdmin )Wio o Chem o pHs <br /> GtA L�VVrKY <br /> is o Researcher AZA to Professor rnAdmin ;d io o Chem o PHS <br /> ✓A M �=I <br /> 19 4KLSf'1 1..✓'�f�h l - Researcher o TA o Professor oAdmin oBio hem o PHS <br /> 20o Researcher o TA4tProfessor oAdmin oBlo em in PHS <br /> eYr �St; <br /> 21 '�Researcher'p TA o Professor oAdmin oBio ty7 Chan <br /> i <br /> n <br /> 'S <br /> 22 cher A o Professor oAdmin oBio hem <br /> I have attended Pacifies Safety Refresher,lab safety protocols and read Annual Asbestos Letter. <br /> I understand it and am willing to comply with all that has been discussed. If i have any question Page I of 3 Version 5.1(Sep 2010) <br /> on any aspect of safety,i will contact my Supervisor or Dept Chair or Risk Management or HR <br />