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y <br /> 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: RVOI <br /> Department: Safety <br /> Repository Location: Sharepoint <br /> Employee Employee Employee Trained Date <br /> Printed Name ID# Shift Initials <br /> XC�iij,�'7 L, uo _ ` G <br /> er a An— 3CO7 i- i- "-a <br /> -A►,C(,A `1 602`'1&54 t 5 ( • (o 2 o <br /> y v v> i.ti� /V t z <br /> Z0 C-0 Ak Wat N - 700)77y7 (5t— it-6'aJ <br /> s ►!—�(�--Z02 <br /> C' wn <br /> -'LL 1Cj�7�f s r' <br /> (to v;i o V 6(-- 6, Z O <br /> 0632 -17z 1 /- c-Lo <br /> IWAI <br /> tea✓ 3 �3 � <br /> HR (fi S 023 2r)J -(L—V <br /> '00' 9 4� 70-15 T7C 21-5) <br /> I certify that the personnel listed-abov receive he ing as indicated on this form. <br /> Trainer/Supervisor Name: — Date: <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 /> ) <br /> FORM1601A-Training Verification Form(By Item)Rev06 Printed 11/5/2020 1'08 PM <br />