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HOLT M (:)'i <br />orl(worx" s t 6 it E <br />Employee Cal/OSHA, CaI/EPA <br />Training Record <br />l �� Al 011�c <br />EMPLOYE` NAME: Last, Fimt, ML (Print) Employee # Jo¢ The <br />DWISION / DEPARTMENT LOCATION <br />Trainin <br />References <br />Fr uen <br />Trainin Date <br />m b e Si Instructor <br />Re uired <br />IIPP (injury/illness Prevention) <br />CCR Title 8, GISO 3203 <br />Ind <br />Emergency Action Plan <br />OCR Title 8, GISO 3220 <br />Initial <br />/ <br />1 _ <br />Fre Prevention Plan <br />CCR Tdk 8, GISO 3221 <br />Intal <br />Hazardous Communication <br />OCR Title 8, GISO 5194 <br />'Initial <br />R ht to Know <br />CCR Title 8, GISO 5194 <br />Lockout-Tagout <br />OCR Title 8, GISO 3314 <br />'Inital <br />' ' v <br />Personal Protective E-,-'--- <br />CCR Title 8, GISO 3380 <br />Hazardous Material M mL <br />HSC Section 25500 <br />1 lnitia <br />/ <br />Spill Prevention/Control Plan <br />CRT Title 40, Part 112 <br />Initial <br />—Initia <br />Hearin Conservation <br />CCR Title 8, GISO 5097 <br />Respirator Protection <br />OCR Title 8, GISO 5144 <br />—Initial <br />Fire Extin uisher <br />CCR Title 8, GISO 5161 <br />""Initial <br />1 <br />a6 <br />Ergonomics <br />CCR Title 8, GISO 5110 <br />—Initia <br />/ <br />Hazardous Waste Management <br />OCR Title 22, 66265 <br />Lift Truck <br />29 CFR 1910.178 <br />—Initial <br />// <br />Initial <br />Hoist/Cranes <br />CCR Title 8, GISO 4884 <br />Machine Guardin <br />OCR T Ie 8, GISO 4243 <br />'Initia <br />' <br />Back Injury Prevention <br />CCR Title 8, GISO 3203 <br />Initial <br />Fall Protection <br />OCR Title 8, GISO <br />Initial <br />/ <br />✓ <br />Blood Bome Patho ens <br />CCR Title 8, GISO 5193 <br />""Initial, <br />/ ' <br />Code of Safe Practices <br />OCR Title B, GISO 3D3 <br />Initial <br />Sli Tri 8 Falls <br />CCR Title 8, GISO 3203 <br />Initial <br />, , <br />Blocking 8 Cribbing <br />CCR Title B, GISO 3203 <br />*Initial <br />�" 6 <br />Other R uired Trainin <br />Smith System <br />CHP Driver Traiiniin y <br />NOTE: Retain this training torn for duration employee is employed by Haft of California $tJb(i11t <br />' indicates additional training If new materiallprocedure is introduced to work area <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 he/she has received training in subject matter <br />FORM SM301 <br />