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UNIFIED WESTERN GROCERS (ETP 01-0279) <br />Classroom Training Roster <br />Module: Module Nae/Tye of Training: Hrs: 0.5 Date: July , 2005 <br />Class Name: _Underground Storoe Tank Attendant Training START TIME: hours END TIME: <br />Stockton, CA <br />TRAINEE NAME JOB EMPLOYEE EMPLOYEE TRAINEE SIGNATURE (INK) SUPERVISOR NAME SPERVISOR <br />Print Last, First NUMBER EXT Print Last, First EXT <br />1 {� e Z n 3(S396 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />9 <br />10 <br />11 <br />12 <br />13 <br />14 <br />15 <br />16 <br />17 <br />18 <br />19 <br />WE <br />Print instructor Name Instructor SigWiture Instructor Emp No. <br />By my signature, I am certifying that I have the authority to sign on behalf of the Contractor and that I have verified with the applicable trainee(s) supervisor(s) that <br />the absences from training noted above are excused. <br />UN126C <br />Contractor's Signature for Absences <br />