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Hazard Communication Training Employee <br />Acknowledgment r <br />I acknowledge that I have completed the Right -to -Know Hazard Awareness Program. <br />I have received information and training on the following: <br />• Rules of Chemicals <br />• Chemical Container Labeling <br />• Safety Data Sheets <br />+ Chemical List specific to my location <br />• Helium <br />• Co2 <br />How to use Chemical Personal Protective Equipment <br />+ Fire Extinguisher Use <br />All team members must receive refresher training yearly. The team member must then <br />sign and date below each time they have received the Hazcom training. Store this <br />document in the team member's file. <br />,p\.ArV, a,, )g.VI S <br />Printed Name <br />A,)7,f,l (-- <br />Signature <br />Signature <br />Signature <br />Signature <br />Signature V <br />-1113 _/_� <br />Date <br />Date <br />Date <br />Date <br />Date <br />to <br />