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i <br />J <br />1% <br />Form 9/I%PP <br />DEUEL VOCATIONAL INSTITUTION <br />CY, CALIFORNIA <br />SB 198 <br />INDIVIDUAL W4pLoyEE TRAINING .®®' <br />DOCUMENTATION <br />INITIAL TRAINING <br />Name of Trainer — 11c Paulsen <br />Training Subject <br />Training Materials Used <br />Name of Employee <br />Date of Nire/Assignrient <br />the following areas:hereby certify that %received training as described above in <br />The Potential occupational hazards in general in the work area and associated with my job <br />assignment, <br />❑ The Codes of Safe Practice which indicate <br />the safe work conditions, safe work practices and <br />Personal Protective equipment required for my work. <br />❑ The hazards of any, chemicals to which% �" <br />material safety data sheets for QxPosed and my right to information contained on <br />chemicals, and how to understand this info,7Mtion. <br />My right to ask any questions, or i any information to the <br />directly or aronymanly without fear of reprisal, employer on safety either <br />Disciplinary procedures the employer will use to enforce <br />ooaPliance with Codes of Safe <br />% understand this training and agree to comply with <br />the Code of Safe Practices for my work area. <br />Employee Signature <br />Date <br />page 1of1 <br />30 194/FOrm 9/1ndividual Training <br />