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H LT j ` MQ Rental of California S ( 9 9 [ Employee Cal/OSHA, Cal/EPA Training Record e � EMPLOYEE NAME: Last, Firs I. (Print) Employee # Jeb Title�5 -�: DIVISION / DEPARTMENT ��5LDCATION Required Training References Frequency Training Date Employee Signature Instructor IIPP (Injury/Illness Prevention) CCR Title 8, GIS1 3203 Initial / Emergency Action Plan CCR Title 8, GIST 3220 Initial Fire Prevention Plan CCR Title 8, GISO 3221 Initial 9— —Hazardous Hazardous Communication CCR Title 6, GIS 5194 'Initial Right to Know CCR Title 8, GIS: 5194 Initial 9-7 Lockout-Tagout CCR Title 8, GISO 3314 'Initial g— Personal Protective Equipment CCR Title 8, GISO 3380 *Initial t Hazardous Material M mt. HSC Section 25504 Initial t Spill Prevention/Control Plan CRT Title 40, Part 112 Initial y Hearing Conservation CCR Title 8, GISO 5097 —Initial �— Iec.Araleeliea CCR Title 8, GISO 5144 —Initial Fire Extinguisher CCR Title 8, GISO 5161 —Initial 7 Ergonomics CCR Title 8, GISO 5110 14 e4ie-, Hazardous Waste Management CCR Title 22, 66265 Initial I 29 CFR 1910.178 •••Initial Hoist/Cranes CCR Title 8, GISO 4884 Initial 19 Machine GuardingCCR Title 8, GISO 4243 _Initial —2 Back Injury Prevention CCR Title 8, GISO 3203 Initial 17-2-7 Fall Protection CCR Title 8, GISO Initial 2 Blood Bome Pathogens CCR Title 8, GISO 5193 —Initial 4 �Z CCR Title 8, GISO 3203 Initial Slips, Trips, & Falls CCR Title 8, GISO 3203 Initial p f Blocking & Cribbing CCR Tide 8, GISO 3203 'Initial fA II NOTE: Retain this training form for duration employee is employed by Holt of California. Indicates additional training if new materlaUprocedure is introduced to work area. Submit '• 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 SAOOot