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f <br />ntal <br />T B E <br />Employee Cal/OSHA, CaUEPA <br />Training Record <br />'Z Ifc <br />EMPLOYEE NAME: List, First, NII. (Print) Empl. # Job Title <br />Ft'e <br />DIVISION/DEPARTMENT LOCATION <br />Required Training <br />IIPP (Injury/Illness Prev. <br />Emergency Action Plan <br />Fire Prevention Plan <br />References Frequency Date Trng. Employee Sign. Instructor <br />CCR Title 8, GISO 3203 Initial <br />" GISO 3220 Initial <br />GISO 3221 Initial <br />Hazardous Comm. <br />" GISO 5194 *Initial <br />LockoutTagort <br />GISO 3314 *Initial <br />Personal Protective Eq. <br />GISO 3380 *Initial <br />OSHA Right to Know <br />CaUOSHA Initial <br />Haz Material Mnmgt <br />HSC section 25500 Initial G <br />Spill PrevJControl Plan <br />CFR Title 40, Part 112 Initial <br />Hearing Conservation <br />CCR Title 8, GISO 5097 Initial/annual <br />Respirator Protection <br />GISO 5144 Initiallannual <br />Fire Extinguisher <br />GISO 5161 Initial/annual <br />Ergonomics <br />GISO 5110 ** <br />Haz Waste Mnmg . <br />CCR Title 22, 66265 Initial/annua!^j'f % z) <br />Lift Truck <br />29 CFR 1910.178 Initial/annual <br />Hoist/Cranes <br />MID 4884 Initial <br />Other req. Training: <br />Smith Systems <br />Initial <br />CHP Driver Training <br />Initial <br />NOTE: Retain this training form for duration employee is employed by HOLT of California <br />* indicates additional training if new material/proceeds is introduce d th work area <br />** indicates initial training if department employee reports a repetative motion injury <br />FORM SA0001 <br />