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Employee Cal/OSHA, Cal/EPA Training Record EMPLOYEE NAME: Last, First, MI. (Print) Employee # Job Title r DIVISION / DEPARTMENT LOCATION Required Training References Frequency Training Date Employee Signature Instructor IIPP (Injury/Illness Prevention) CCR Title 8, GISO 3203 Initial Emergency Action Plan CCR Title 8, GISO 3220 Initial Fire Prevention Plan CCR Title 8, GISO 3221 Initial Hazardous Communication CCR Title 8, GISO 5194 'Initial Right to Know CCR Title 8, GISO 5194 Initial Lockout-Tagout CCR Title 8, GISO 3314 'Initial Personal Protective Equipment CCR Title 8, GISO 3380 'Initial Hazardous Material Mgmt. HSC Section 25500 Initial Spill Prevention/Control Plan CRT Title 40, Part 112 Initial C Hearing Conservation CCR Title 8, GISO 5097 —Initial Respirator Prcte-:tion CCR Title 8, GISO 5144 —Initial Fire Extinguisher CCR Title 8, GISO 5161 —Initial Ergonomics Hazardous Waste Management CCR Title 8, GISO 5110 CCR Title 22, 66265 —Initial Lift Truck 29 CFR 1910.178 —Initial Hoist/Cranes CCR Title 8, GISO 4884 Initial Machine Guarding CCR Title 8, GISO 4243 —Initial Back Injury Prevention CCR Title 8, GISO 3203 Initial Fall Protection CCR Title 8, GISO Initial Blood Borne Pathogens CCR Title 8, GISO 5193 —Initial Code of Safe Practices CCR Title 8, GISO 3203 Initial Slips, Trips, & Falls CCR Title 8, GISO 3203 Initial Blocking & Cribbing CCR Title 8, GISO 3203 `Initial may.. •,y. Smith System CHP Driver Training NOTE: Retain this training form for duration employee is employed by Holt of California. ' Indicates additional training if new material/procedure is introduced to work area. $U?I111f " Indicates initial training if department employee reports a repetitive motion injury. ' Indicates annual or refresher training required. NOTE: By signing this form, employee states he/she has received training in subject matter. FORM SAOW1