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<> Sumiden Wire Products Corporation <br /> 1412 EI Pinal Drive Stockton, CA 95205 <br /> SWPC Phone:(209)466-8924 Fax:(209)941-2990 <br /> New Hire Safety Training <br /> Employee Name: <br /> This new employee has been told that all employees must comply with plant safety regulations and <br /> safety practices. The Employee has been told that safety instructions will be provided by his or her <br /> supervisor.The safety instructions should include each of the followings. <br /> The supervisor will indicate those she/he has explained to the employee and have the employee sign <br /> the acknowledgement. The supervisor will then submit this form to the plant manager. <br /> [ Initial ] <br /> General: Safety Rules [ ] <br /> Lockout/Tagout [ ] <br /> Videos: MSDS [ ] <br /> If you have seen the video Personal Protective Equipment [ ] <br /> while you worked with us Lockout/Tagout(Maintenance Department Only) [ ] <br /> through a temp agency,you Overhead Crane [ ] <br /> can skip the video by writing Forklift Operations [ ] <br /> the date you've watched. <br /> Fire Protection [ ] <br /> Job Specific hazards: Chemical [ ] <br /> Operation Equipment [ ] <br /> Tools [ ] <br /> Injury History [ ] <br /> Explanation of Plant Map: Evacuation Plan [ ] <br /> Fire Extinguisher [ ] <br /> Fire Hydrant [ ] <br /> First Aid Station [ ] <br /> Safety Shower [ ] <br /> MSDS Book [ ] <br /> Personal Protective Equipment: <br /> Safety Glasses [ ] <br /> Gloves [ ] <br /> Steel-toed Shoes [ ] <br /> Ear Plugs [ ] <br /> Safety Problem Reporting Form [ ] <br /> Injury Reporting Procedures [ ] <br /> Employee Responsibility for maintaining a clean work area [ ] <br /> Signed: Signed: <br /> Employee Date Supervisor <br /> COMPANY COPY <br />