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.'I'Z > <br /> Employee Training Attendance Roster MAR 17 2016 <br /> Dealership Name:. '�Q ( (� �YIAS� C AT -1P� p , IUZLIki ENViRd�lMENTRl <br /> r 1 . t k a <br /> HAZARD COMMUNICATION S EMERGENCY RESPONSE <br /> READ THE FOLLOWING BEFORE SIGNING <br /> I acknowledge that 1 have received Hazard Communication Training. During this training I was made generally aware of hazards <br /> associated with chemicals present at the dealership,steps I can take to reduce these hazards,and typical responses in the event of <br /> an emergency. 1 was also made aware of chemical specific information available to me in the forth of product labels and Safety <br /> Data Sheets(SDS). I was made aware of the Global Harmonization Standard(GHS)changes to the HAZCOM standard. Changes <br /> that include: Hazard Classification, labeling requirements, and SDS fornatfing, i understand that I may review the dealership's <br /> Hazard Communication Program and SDSs any time during my work shift. <br /> I also acknowledge that I have received Emergency Response Training. During this training I was made aware of guidelines for <br /> responding to a fire or explosion (including use of portable hand-held fire extinguishers), a release of hazardous materials, and <br /> certain natural disasters. I was also informed of the dealership's evacuation assembly pant. <br /> I understand that the dealership alone is responsible for environmental and safety issues at the facility,and that 1 should contact my <br /> supervisor with any questions or concerns that I have about these matters. <br /> Printed Name Job Descri tion Si nature <br /> 2 <br /> 3 F1'V2 ✓✓ // <br /> 4 <br /> 5 1S wrw:5o� <br /> 6 �ivt r P 4 <br /> i 7 hti an q s <br /> 8 p7izu, A10�J 1 <br /> s is pl f, <br /> 10 ar it <br /> 11 <br /> 12 j U <br /> 13 <br /> 14 <br /> 15 `w' ' ,F 5rI L�- <br /> 18 <br /> 17 1—L-)?C- RZ t-I <br /> 18 <br /> 19 e �ti S vis J'9/ <br /> 20 (v( ✓ <br /> 21 t 0 144 <br /> 22 <br /> 23 ` <br /> I certify that I conducted Hazard CommunieationtRight-to-Know and Emergency Response Training in accordance with Federal & State <br /> requirements with the above listed employees. <br /> . 1<165y(an 1 >&_4rIA 1g, Iq <br /> KPA Engineer(Pnnt Nama1 J V�— <br /> SignaNre <br /> Date <br />