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�� Df <br /> Employee CaUOSELA,CaUEPA <br /> 1,2 Training Record <br /> z <br /> EMPLOYEE NAME: Last,First,NII. (Print) E m 77# Job Title <br /> DWISION/DEPARTMENT LOCATION <br /> Required Training References Frequency Date Trng. Employee Sign. Instructor <br /> IIPP(Injury/Illness Prev. CCR Title 8,GISO 3203 Initial <br /> Emergency Action Plan GISO 3220 Initial <br /> Fire Prevention Plan GISO 3221 Initial <br /> Hazardous Comm. GISO 5194 *Initial <br /> Lockout-Tagout GISO 3314 *Initial <br /> Personal Protective Eq. GISO 3380 *Initial <br /> OSHA Right to Know Cal/OSHA Initial <br /> Haz- Material Mnmgt HSC section 25500 Initial -- - <br /> Spill PrevJControl Plan CFR Title 40, Part 112 Initial <br /> Hearing Conservation CCR Title 8,GISO 5097 Initialfannual <br /> Respirator Protection GISO 5144 Initial/annual <br /> Fire Extinguisher GISO 5161 Initial/annual <br /> Ergonomics GISO 5110 '* <br /> Haz.Waste Mnmgt CCR Title 22,66265 Initial/annual <br /> Lift Trude 29 CFR 1910.178 Initial/annual <br /> Hoist/Cranes GISO 4884 Initial <br /> Other req.Training: <br /> Smith Systems Initial <br /> CHP Driver Training 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 /> +S rye rt1 <br /> Pratc vcW pfc—&-(*J I c <br />