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Hazardous Materials Training and Page <br /> Jiffy Lube" Exposure Warning <br /> 1, herewith acknowledge that during the course of my employment at Jiffy Lube <br /> Center No. . ("the Company")that I will be exposed to several hazardous materials. <br /> Sorne of these materials may contain Benzene which is known by the State of California to <br /> cause cancer. <br /> I further acknowledge as part of my pre-employment training, I have been instructed <br /> in the safe handling and disposal of the hazardous materials which I may come in contact <br /> with during the course of my employment. <br /> I am aware that the Company has a Business Emergency Response Plan. I have <br /> read and understand its contents and the Material Safety Data Sheets (MSDS) for the <br /> hazardous materials which 1 may handle during my employment. <br /> I understandthat it is my responsibility wearthe personal protective equipment which <br /> 1 have learned the proper use of during by pre-employment training. <br /> 1 understand further that it is my responsibility to report to my supervisor any spili, <br /> release or threatened spill or release of a hazardous material. <br /> I accept employment with fuli knowledge of the potential health risk and release the <br /> Company and .!iffy Lube international, In . from any and all claims resulting from my <br /> exposure to hazardous materials. <br /> Acknowledged: <br /> 0 <br /> C 6 <br /> -U <br /> rz <br /> - <br /> � om - <br /> �= Signature <br /> c�4 <br /> w <br /> e Print your name <br /> Socia!Security Number <br /> Date Signed <br />