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Employee Cal/OSHA, Cal/EPA <br />Training Record <br />�oSEff , UI-) LO . 1---e ,I� Sec uccp <br />EMPLOYEE NAME: Last, First, ML (Print) Empl. # Job Title PQM p <br />1-49TIl �C* Dom. <br />DWISION/DEPARTMENT LOCATION <br />Required Training <br />References Frequency Date Trng. Employee Sign. Instructor <br />IIPP (Injury/lllness Prev. <br />CCR Title 8, GISO 3203 Initial <br />Emergency Action Plan <br />GISO 3220 Initial <br />Fire Prevention Plan <br />GISO 3221 Initial <br />Hazardous Comm. <br />GISO 5194 *Initial <br />LodmutTagout <br />GISO 3314 *Initial <br />Personal Protective Eq. <br />GISO 3380 *Initial <br />OSHA Right to Know <br />CaI/OSHA Initial <br />Haz Material Mnmgt <br />HSC section 25500 Initial a - cis <br />Spill PrevXontrol Plan <br />CFR Title 40, Part 112 Initial <br />Hearing Conservation <br />CCR Title 8, GISO 5097 Initiallannual <br />Respirator Protection <br />GISO 5144 Initiallannual <br />Fire Extinguisher <br />GISO 5161 Initial/annual <br />Ergonomics <br />GISO 5110 ** <br />Haz Waste Mnmgt <br />CCR Title 22, 66265 Initial/annual _ O <br />Lift Truck <br />29 CFR 1910.178 Initial/annual <br />Hoist/Cranes <br />GISO 4884 Initial <br />Other req. Training: <br />Smith Systems <br />Initial <br />CHP Driver Training <br />Initial <br />NOTE: Retain this training farm for duration employee is employed by HOLT of California <br />* indicates additional training if new material/proceedure is introduced to work area <br />** indicates initial training if department employee reports a repetitive motion injury <br />FORM SA0001 <br />