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XPO Training Verification Form <br /> This form is intended to record personnel that require new/updated training on the listed document(s)and as verification training is complete. <br /> Employee(s): Upon completion,enter your initials and date trained. If additional assistance is needed,please notify your supervisor. <br /> Document Name: Emergency Evacuation Plan and Procedure <br /> Rev. Number: RV01 <br /> Department: Safety <br /> Repository Location: Sharepoint <br /> Printed Name Employee I Employee Employee Trained Date <br /> 1D# Shift Initials <br /> a Ica <br /> 5OA& / 5r /�v it 2p <br /> G <br /> 1 002"1 !2 } � !t Id 2•J <br /> r n1m l -,�- II 0 <br /> <u COG-160�27gl l 5- <br /> y�C. tnv�a�-- �� 00 X3/3 � S�-" � •li �, '' � <br /> U 1k, <br /> '1 <br /> C <br /> v S <br /> I certify that the personnel listed-iov receive he ing as indicated on this form. <br /> � t <br /> �- Date: <br /> Trainer/Supervisor Name: <br /> The official record of training and retention of this document are addressed on the program record retention matrix. <br /> NOTE:Training verification may be distributed and received complete via email,in lieu of a signature or initials and date at the <br /> discretion of facility management.In such cases,it is not necessary to print this form. <br /> FORM1601A-Training Verification Form(By Item)Rev06 Printed 11/5/2020 1:08 PM <br />