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HOLTek e <br />orcr,t s <br />Employee Cal/OSHA, Cal/EPA <br />Training Record <br />:'� �t � �ti, �-ti , � �° � C-� 1 >✓N � moi/ � �� ci2_.�r� i G <br />EMPLOYE NAME: Last, First, ML (Print) Employee # Job Title <br />DMSION / DEPARTMENY LOCATION 41 <br />Required Training <br />References <br />Frequency <br />Training Dake <br />loyee Signature Instructor <br />IIPP (Injuryfillness Prevention) <br />CCR Idle 8, GISO 3203 <br />Initial <br />1161511e. <br />'L <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 />�S <br />Right to Know <br />CCR Title 8, GISO 5194 <br />Initial <br />Lockout -Ta out <br />CCR Title 8, GISO 3314 <br />'Initial <br />Personal Protective Equipment <br />CCR Title 8, GISO 3380 <br />'Initial <br />l0 S D.S <br />4Y7j�w <br />Hazardous Material M mt. <br />HSC Section 25500 <br />Initial <br />/� �✓ s <br />/`� <br />Spill Prevention/Control Plan <br />CRT Title 40, Part 112 <br />Initial <br />Hearing Conservation <br />CCR Title 8, GISO 5097 <br />"'Initial <br />i Respirator Protection <br />CCR Idle 8, GISO 5144 <br />'"'Initial <br />L" <br />Fire Extinguisher <br />CCR Title 8, GISO 5161 <br />—Initial <br />h 5 d5 <br />4-1 <br />Ergonomics <br />OCR Title 8, GISO 5110 <br />Hazardous Waste Management <br />OCR Title 22, 66265 <br />—Initial <br />Lift Truck <br />29 CFR 1910.178 <br />—Initial <br />HoisNCranes <br />OCR Title 8, GISO 4884 <br />Initial <br />7� C <br />Machine Guarcling <br />CCR Title 8, GISO 4243 <br />"Initial <br />4Wd <br />x1d11J <br />Back Injury Prevention <br />CCR Title 8, GISO 3203 <br />Initial <br />Jr L <br />il% <br />Fall Protection <br />CCR Title 8, GISO <br />Initial <br />QS <br />Blood Bome Pathogens <br />OCR Tale 8, GISO 5193 <br />"'Initial <br />Code of Safe Practices <br />OCR Title 8, GISO 3203 <br />Initial <br />Slips, Trips, & Falls <br />CCR Title 8, GISO 3203 <br />Initial <br />Blocking & Cribbing <br />OCR Title 8, GISO 3203 <br />'Initial <br />/0 OS <br />G2 ci4f//rJ6%�ii <br />omer <br />NOTE: Retain this training form for duration employee is employed by Holt of California. <br />" Indicates additional training it new matedaUprocedure is introduced to work area. <br />Indicates initial training ff department employee reports a repetitive motion injury, <br />— Indicates annual or refresher training required. <br />NOTE: By signing this form, employee states helshe has received training in subject matter. <br />FORM SMO01 <br />