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HOLT M ' I <br />a Rental <br />of California S I 0 8 [ <br />Employee CaUOSHA, Cal/EPA <br />I �•' ^ Training Record <br />�'I�'�" � i. I � �•y �U � - Q��nt+�T�rl� I��ii�(Ci�G <br />EMPLOYEE NAME: Last, First, MI. (Print). Employee 9 Joh Title <br />s <br />s _�f ",-i � r <br />DIVISION / DEPARTMENT LOCATION <br />Required Training <br />References <br />Frequency <br />Training Date Employee Signature Instructor <br />IIPP (Injury/Illness Prevention) <br />CCR Title 8, GISO 3203 <br />Initial <br />Emergency Action Plan <br />CCR Title 8, GISO 3220 <br />Initial <br />Fire Prevention Flan <br />CCR Title 8, GISO 3221 <br />Initial <br />' <br />Hazardous Communication <br />CCR Title 8, GISO 5194 <br />`{ <br />� 1 <br />Right to Know <br />CCR Title 8, GISO 5194 <br />Initial ,•' y <br />I <br />Lockout-Tagout <br />CCR Title 8, GISO 3314 <br />Initial <br />± <br />Personal Protective Equipment <br />CCR Title 8, GISO 3380 <br />Hazardous Material M mt. <br />HSC Section 25500 <br />Initial 'ii" ` <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 />Respirator Protection <br />CCR Title 8, GISO 5144 <br />"Initial <br />Fire Extinguisher <br />CCR T -We 8, GISO 5161 <br />—Initiali.: , <br />Ergonomics <br />CCR Tille 8, GISO 5110/r; <br />S <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 !"J7'.f <br />Machine Guarding <br />CCR Title 8, GiSO 4243 <br />-i <br />—Initiali;J <br />Back Injury Prevention <br />CCR Title 8, GISO 3203 <br />Initial <br />Fall Protection <br />CCR Title 8, GISO <br />Initial <br />Blood Borne Pathogens <br />CCR Title 8, GISO 5193 <br />—Initial'-=•;` <br />i <br />Cade of Safe Practices <br />CCR Title 8, GISO 3203 <br />Initial <br />Slips, Trips, & Falls <br />CCR Tille 8, GISO 3203 <br />yy <br />Inifialf).// . <br />Blocking & Cribbing <br />CCR Title 8, GISO 3203 <br />Initial.'�j° <br />Smith System <br />CHP Driver Training <br />If l� <br />NOTE: Retain this training form for duration employee is employed by Holt of California. <br />Indicates additional training if new material procedure is introduced to work area. Submit <br />" Indicates initial training if 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 sAaaol <br />