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Employee Cal/OSHA, CalfEPA <br />Training Record <br />EMPLOYEE NAME: Last, First, ML (Print) Empl. # Job Title Jc <br />Oct, <br />c <br />DIVISION/DEPARTMENT LOCATION <br />Required Training <br />References <br />I Frequency Trng. Employee Sign. Instructor <br />IIPP (Injury/Illness Prev. <br />CCR Title 8, GISO 3203 <br />Initial <br />Emergency Action Plan <br />GISO 3220 <br />Initial <br />Fre Prevention Plan <br />GISO 3221 <br />Initial <br />Hazardous Comm. <br />GISO 5194 <br />"Initial <br />Lod"XA-Tagout <br />GISO 3314 <br />"Initial <br />Personal Protective Eq. <br />GISO 3380 <br />=Initial <br />OSHA Right to Know <br />CaUOSHA <br />Initial <br />Haz Material Mnmg . <br />HSC section 25500 <br />Initial <br />Spill PrevJControl Plan <br />CFR Title 40, Part 112Initial <br />Hearing Conservation <br />CCR Title 8, GISO 5097 <br />Initial/annual <br />Respirator Protection <br />GISO 5144 Initiat/annual <br />Fire Extinguisher <br />GISO 5161 <br />Initial/annual <br />Ergonomics <br />GISO 5110 <br />" <br />Haz Waste Mnmgt <br />CCR Title 22, 66265 <br />Initiai/annual i <br />Lift Trude <br />29 CFR 1910.178 <br />Initiallannual <br />HoistKtranes <br />GISO 4884 <br />Initial <br />Other req. Training: <br />Smith Systems <br />Initial <br />CHP Driver Training <br />Initial <br />NOTE: Retain this training form 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 repetative motion injury <br />FORM SA0001 <br />