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3 <br />7 <br />8 <br />—9 <br />10 <br />11 <br />12 <br />13 <br />14 <br />15 <br />016 <br />17 <br />18 <br />19 <br />20 <br />21 <br />22 <br />23 <br />24 <br />25 <br />26 <br />27 <br />28 <br />29 <br />30 <br />KPA Con ant (Printed <br />11(pA Emergency Response Employee Attendance Roster <br />iFacility Name: PPPM1 :/e).- e- c arra_ ,..,,,d pr./6'er- 139 1...4(‘ 4 <br />READ THE FOLLOWING BEFORE SIGNING <br />I acknowledge that I have received Emergency Response Training on the subject listed above. During this training, I was made aware of guideline for responding to a fire <br />or explosion (including use of portable hand-held lire extinguishers), a release of hazardous materials, natural disasters and facility emergency situations. I was informed <br />of the facilities evacuation assembly point. I also understand that the facility alone is responsible for environmental and safety issues at all facilities and that, should I have <br />any questions or concerns on such matters, I should address them to my supervisor. <br />Training Subject: Emergency Response for Emergency Response and Action Plans <br />Signature <br />I I I I I l G NJ I • 4 . I 1 , _.,._ _ _. .,_ _ <br />/ <br />1V I. <br />ibgs I 1A44— 5'971-vice Pace-T -Ne <br />Omott- .5- Veatts i-e(h Or <br />; P i s 11.s.c.1 us- Se ivtMAs4,47c,P- <br />" ...... 4.,,A 6v , -rec.k <br />iive_epr fonmiez- fez,f-1 <br />m Ka C.11r-056e../-1 .- 7-0-ch <br />.5--t-e ve o /2 K. ;\-/T., r A 7 /1/..---- <br />it tigi`c— S c —r1 're Ck -->k--- <br />-J-oirtilly .cz,e_ -r-4)4 <br />-to c - , - lew 4 <br />-I/ii G . rcerb <br />(Av\- <br />--e-,f-m-eit <br />. V 3,0t.e -(.1--£,N9 1-v ea Er--4 ri; k <br />I ,yr <br />tat & 1 _ riCk <br />ri............„2 <br />I <br />, <br />, <br />I certify that I conducted Emergency Respon ming in accordance with Federal and State Requirements with the above listed employee. <br />Signature <br />epi 1312Ny' <br />Date <br />Page 1