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MOM D'4vi l l� <br />EMPLOYEE ACKNOWLEDGMENT FORM <br />I have received my refresher training and read my copy of the Injury and Illness <br />Prevention program for the Lodi News -Sentinel which included: Fire Prevention, <br />evacuation, emergency assistance for medical & fire, hazard communications, and <br />proper communications with employees. <br />Signature <br />Lodi News -Sentinel IPP 3 <br />Revised 3/27/17 <br />Date <br />