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_ Appendix a _ <br /> (Stockton Plan <br /> S�Ct'acraN PU404,-r (Areal Department) <br /> CERTIFICATE OF TRAINING <br /> IN <br /> THE USE OF PERSONAL PROTECTIVE EQUIPMENT <br /> I (Print Name) �qYttil49 do hereby certify that I <br /> have received and understand training pertaining to Personal Protective <br /> Equipment associated with,the performance of my job and workplace. I agree to <br /> wear this equipment while working, and understand that I will be subject to <br /> disciplinary action if I do not follow the requirements of this location's.Personal <br /> Protection Equipment Policy. <br /> I will inspect my equipment on a regular basis to ensure that it is clean and in <br /> good condition. I will contact management immediately if I should need new <br /> equipment. 1% <br /> The training I received included the following elements: <br /> • When personal protective equipment is necessary. <br /> • What personal protective equipment is necessary. <br /> • That additional PPE may be required if performing another job <br /> task. <br /> • How to properly don, adjust, and wear personal protective <br /> equipment. <br /> • PPE limitations <br /> • Proper care, maintenance, useful life and disposal of personal <br /> protective equipment. <br /> Employee'sSignature'- :Date <br /> Instructor (Print Name) sfructor's Signature <br /> 9 <br />