Laserfiche WebLink
GENERAL SAFETY ORIENTATION CHECKLIST <br /> NAME: I'l ¢ I J1 , <br /> ZZO 7- 0 <br /> PRJNT) ST <br /> /DATE-OF-HIRE <br /> COMPANY ASSIGNED: 4 �I To M k'tA l` TYPE OF WORK: _I ALtC'LC p/, r U(= 2 <br /> THE FOLLOWING ITEMS HAVE BEEN DISCUSSED AND UNDERSTOOD BY ME: <br /> ❑ CHECK HERE <br /> COMMENTS: <br /> COMPANY SAFETY POLICIES/PROGRAMS A& Ar7 ,44. <br /> D SAFETY RULES,GENERAL AND JOB SPECIFIC �'!_ J QCC J G N T ay U <br /> Er SAFETY RULES ENFORECEMENT PROCEDURES t'✓:4'L ,.(�4'r'���y I� n,,tST f R n�.�-r`c.l:T r7 <br /> HEN,WHERE AND HOW TO REPORT INJURIES S�AnI'=Oily D <br /> WHEN,WHERE AND HOW TO REPORT UNSAFE CONDITIONS 5'&N!111 pTi� - V L R <br /> Q'REVIEW OF FIRE/EMERGENCY EVACUATION PLAN �Cy/(`�sW (`�1.J y c— y1^A-P <br /> LOCATION AND USE OF FIRE EXTINGUISHERS /n/ 7:i!e� C I0/tS-S <br /> lid<FE WORK CLOTHING No 15'ff d A r /I/V a 6 .( S,4-O(`.S <br /> L3/HOUSEKEEPING RULES,I.E.:SPILL CLEANUPS,ETC. Nk T,-li6m !> �(=rO R 1 - <br /> ['I'�AZARD COMMUNICATION PROGRAM: I S$Ut=17 P p <br /> MSDS,IIPP,HAZCOM `'✓il S O S /A S/ U P <br /> 13/SPECIFIC HAZARDS TO JOB ASSIGNMENT A'L � + V k�- 2!2 A^,`I--n T- <br /> a ASSIGNMENT/USE/CARE OF PERSONAL PROTECTIVE EQUIPMENT S trr i 6GAS I>5 77inf C> idyD p AA13i Al <br /> R PROPER LIFTING PROCEDURES(VIDEO) (s M V .Q-]' j�/q a rI s' c [Oc <br /> G3 HEAT STRESS AND HEAT STROKE PREVENTION L. T v Fr=Lt X-rF �fc I t yv V(6tiE ) <br /> '4- r- - a-w Q[ <br /> IMPORTANT.•IF THIS EMPLOYEE IS TRANSFERRED TO ANOTHER JOB ASSIGNMENT,IT IS MANDATORY THAT <br /> A NEW SAFETY ORIENTATION CHECKLIST FORM IS FILLED OUT, <br /> THE ABOVE ITEMS HAVE BEEN DISCUSSED WITH ME,I HAVE BEEN ABLE TO ASK <br /> QUESTIONS AND HAVE MY QUESTIONS ANSWERED TO MY SATISFACTION: <br /> EMPLOYEE: /_I- n,fc-) J� V v—: P, DATE: <br /> (SIGNATURE) <br /> SUPERVISOR: DATE: <br /> (SIGNATURE) <br /> N:\Safety\GENERAL SAFETY ORIENTATION CHECKLIST.doc <br />