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ie <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 />Dumb Nom; <br />Emergency Response and Notification Chemical Spills <br />Rev. Nnmr. <br />RV02 <br />Department: <br />Safety <br />VPox. <br />Sharedrive <br />Ii�€HteYee <br />-od, Date <br />'l a /5 � s <br />�- 4AJ <br />CIV <br />nim <br />"( 4 vt <br />LALN- <br />Zr <br />1� <br />I certify that the personnel listed above received the training as indicated on this form. <br />Trainer/Supervisor Name: "" t� Date: )I/( 2,/Z, <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 12/3/2020 7:47 PM <br />