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?HE PAPE GROUP, INC. REQUIRED SAFETY TRAINING FOR NEW MEMBERS Member Name: Hire/Transfer Date: Job Title: Company/Location: W5 The member must be trained by their Supervisor(or �n scheduled to be trained)in the following topics prior to � MENTA_. beginning work. Documentation of the training is required. y o s, A Note: Do not take your training and documentation responsibility lightly. Documenting that training and/or c Code Completion instruction has taken place can actually increase thed Un t to Date company's liability if such training is inadequate for the a job. • Introduction to members and tour of facility X X X X • Safety Attitude—Review Safety Policy# 5.01 X X X X 074AB23 • Review General Safety Provisions(IIPP)Safety Manual 074AB35 • Housekeeping X X X X 074AA75 Clear aisle ways Clear exits Clean up of spills Responsibility for your area • Violence Response Policy# 5.22 X X X X 074AB37 • Review Workplace Violence Prevention Policy# 5.22 • First Aid—location of kit, stretcher, blanket, eyewash, X X X X and deluge showers. First aid trained personnel. • Emergency Action Plan—911 X X X X 074AB39 Poster with store address Ambulance and Hospital Phone numbers Map of Store and exits, Meeting lace • How to report on the job accidents, incidents, and near X X X X accidents • Have Member attend the first safety meeting held after X X X X date of employment I acknowledge I have received the above training,that I questioned what I did not understand, and that I agree to abide by prescribed work practices and rules of behavior. Member Signature: Date: This member has been trained in the above areas and I am confident in his or her knowledge of and competency in the areas requiring demonstration of safe work practices. Manager Signature: Date: