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LITTLE POTATO SLOUGH MUTUAL WATER COMPNY <br /> 14900 W. HIGHWAY 12 #1 <br /> LODI, CA 95242 <br /> 209-339-1602 <br /> Receipt and Acknowledgment of Training Materials <br /> LPSMWC <br /> Environmental Health Department <br /> A <br /> I, (employee name) �f,� �F� acknowledge I have <br /> received and read the company training anual for Hazardous Materials. I have <br /> been trained in the following topics. <br /> 1. Emergency Response/Contingency Plan procedures <br /> 2. Spill notification procedures <br /> 3. Spill response procedures <br /> 4. Evacuation procedures <br /> I understand the training material subject matter and will apply this knowledge in <br /> my job duties. <br /> Signed, (employee name) <br /> Date: ,2D ' b a,D`�a <br /> � � l <br />