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HOLT� Rental <br />orCalirornia 5 (0 p [ <br />Employee Cal/OSHA, Cal/EPA <br />Training Record <br />7_6 1K-. til <br />EMPLOYEE NAME: Last, First, MI. (Print) Employee # Job Title <br />DIVISION / DEPARTMENT LOCATION <br />av b 17e -s . <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 Plan <br />CCR Title 8, GISO 3221 <br />Initial <br />Hazardous Communication <br />CCR Title 8, GISO 5194 <br />'Initial <br />Right to Know <br />CCR Title 8, GISO 5194 <br />Initial <br />Lockout -Ta out <br />CCR Title 8, GISO 3314 <br />'Initial <br />Personal Protective Equipment <br />CCR Title 8, GISO 3380 <br />'Initial <br />Hazardous Material M mt. <br />HSC Section 25500 <br />Initial <br />Spill Prevention/Control Plan <br />CRT Title 40, Pan 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 Title 8, GISO 5161 <br />—Initial <br />Ergonomics <br />CCR Title 8, GISO 5110 <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 <br />Machine Guarding <br />CCR Title 8, GISO 4243 <br />—Initial <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 />Code of Safe Practices <br />CCR Title 8, GISO 3203 <br />Initial <br />Slips, Trips, & Falls <br />CCR Title 8, GISO 3203 <br />Initial <br />Blocking & Cribbing <br />CCR Title 8, GISO 3203 <br />'Initial <br />Dnver <br />=os <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. <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 SA0001 <br />