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i <br />-A- <br />�Rentai` <br />Employee Cal/OSHA, Cal/EPA <br />_ Training Record <br />�73C� <br />_ EMPLOYEE NAME: Last, First, Ml. (Print) Employee # Job Title 3Cij <br />r , <br />��'�� t -f I"vIL'�� 11� c' v / l��;EL_i.� St-fsJ? �-�` ! �'•�,C_�i C�� sem+ <br />DIVIS�ARTMENT LOCATION <br />Required Training <br />References <br />Frequency <br />Training Date <br />Employee Signature Instructor <br />IIPP (injuryAllness Prevention <br />CCR Title 8, GISO 3203 <br />Initial <br />Emergency Action Plan <br />CCR Title 8, GISO 3220 <br />Initial <br />Fire Prevention Plan <br />CCR Title 8, GISO 3221 <br />Initial <br />Hazardous Communication <br />CCR Title 8, GISO 5194 <br />'Initial <br />Air Toot Safety <br />CCR Title 8, GISO <br />lnitia(41 <br />01 <br />Lockout-Tagout <br />CCR Title 8, GISO 3314 <br />'Initi I <br />Personal Protective Equipment <br />CCR Title 8, GISO 3380 <br />'Initi <br />�ti <br />Hazardous Material M mt. <br />HSC Section 25500 <br />Initial <br />Spill Prevention/Control Plan <br />CRT Title 40, Part 112 <br />Initial <br />Hearing Conservation <br />CCR Title 8, GISO 5097 <br />"`Init I <br />l <br />— <br />Res irator Protection <br />CCR Title 8, GISO 5144 <br />""Initi I <br />/ 1 <br />Fire Extinguisher <br />CCR Title 8, GISO 5161 <br />"'Initial <br />Ergonomics <br />CCR Title 8, GISO 5110 <br />t <br />Hazardous Waste Management <br />CCR Title 22, 66265 <br />—Initial <br />Lift Truck <br />29 CFR 1910.178 <br />"'Initial <br />Hoist/Cranes <br />CCR Title 8, GISO 4884 <br />Initial— <br />Machine Guarding <br />CCR Title 8, GISO 4243 <br />"" Initis <br />` <br />Back Injury Prevention <br />CCR Title 8, GISO 3203 <br />Initial <br />Fall Protection / Ladder <br />CCR Title 8, GISO <br />Initia <br />C_- - <br />Blood Borne Pathogens <br />CCR Title 8, GISO 5193 <br />"'1n ial' <br />= <br />Slips, Trips, & Falls <br />CCR Title 8, GISO 3203 <br />Initia <br />c�� <br />Blocking & Cribbing <br />CCR Title 8, GISO 3203 <br />'Initi <br />Welding Safety <br />CCR Title 8, GISO <br />Initi <br />3 <br />C <br />Office Safety <br />CCR Title 8, GISO <br />Initial <br />Smith System <br />CHP Driver Training <br />� r+ <br />NOTE: Retain this training form for duration employee is employed by Hok of California. <br />Indicates additional training if new material/procedure Is introduced to work area. <br />" Indicates initial training if department employee reports a repetitive motion injury. <br />Indicates annual or refresher training required. <br />NOTE: By signing this forth, employee states he/she has received training In subject matter. <br />FORM SADM1 <br />