Laserfiche WebLink
%"W <br /> GENERAL SAFETY ORIENTATION CHECKLIST <br /> NAME: C vr_ t l 12aol,/ U/a, yr' 7 — /8 -/ / <br /> (PRINT) LAST FIRST MJ DATE-OF-HIRE <br /> COMPANY ASSIGNED: A 42 fl)4; H r TYPE OF WORK: 01"'161- <br /> THE <br /> 1 ✓GvTHE FOLLOWING ITEMS HAVE BEEN DISCUSSED AND UNDERSTOOD BY ME: <br /> ❑ CHECK HERE COMMENTS: <br /> ❑ COMPANY SAFETY POLICIESIPROGRAMS /? ✓4 eN/ 4// /VIB'A a n`,L,:i <br /> ❑ SAFETY RULES,GENERAL AND JOB SPECIFIC �V/> 4ynQ :444 .4, % <br /> ❑ SAFETY RULES ENFORECEMENT PROCEDURES �( /�I, /+-'.9 rn JJ(J h U 5 /C'.✓n <br /> ❑ WHEN,WHERE AND HOW TO REPORT INJURIES S9 ym vgJ0,r417A te A r i <br /> ❑ WHEN,WHERE AND HOW TO REPORT UNSAFE CONDITIONS 5 E y /pto1.2,'lj' f,4t i 12 V )f? <br /> ❑ REVIEW OF FIRE/EMERGENCY EVACUATION PLAN I� ✓r r .✓ '(uL,A ��:'ry <br /> ❑ LOCATION AND USE OF FIRE EXTINGUISHERS )h r-L C k ?b <br /> ❑ SAFE WORK CLOTHING V r n o N nZs <br /> ❑ HOUSEKEEPING RULES,I.E.:SPILL CLEANUPS,ETC. 60 h�J fQ",n ItR l9ioY <br /> ❑ HAZARD COMMUNICATION PROGRAM: j / 2 ;-Ii!. Dm J�U n <br /> MSDS,IIPP,HAZCOM )� ? ''�1 <u J f P <br /> El SPECIFIC HAZARDS TO JOB ASSIGNMENT / II i nT?r,iT!wr f <br /> ❑ ASSIGNMENT/USE/CARE OF PERSONAL PROTECTIVE EQUIPMENT_ y/�fY (` sem f t.J;�! 7';e r w W acat�I R <br /> ❑ PROPER LIFTING PROCEDURES(VIDEO) ¢f't'IArJ / r'� NOS P <br /> ❑ HEAT STRESS AND HEAT STROKE PREVENTION <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 HAYj MY QUESTIONS ANSWERED TO MY SATISFACTION: <br /> EMPLOYEE: err,-- DATE: <br /> (SIGNATURE) GG <br /> SUPERVISOR: IA�wA J� DATE: 7-13-0 <br /> ( (SIGNATURE) <br /> N:\Safety\GENERAL SAFETY ORIENTATION CHECKLIST.doc <br />