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INDIVIDUAL SAFETY TRAINING DOCUMENTATION: REFRESHER TRAINING <br /> Date: <br /> Trainer : <br /> Subjects Covered: <br /> Training Aids Used: <br /> Name of Employee : <br /> Date of Hire/Assignment : <br /> I , hereby cerify that I have received <br /> training as described above in the following areas : <br /> The potential occupational hazards in general in the <br /> work area and associated with my job assignment . <br /> The Codes of Safe Practices which indicate the safe <br /> working conditions , safe work practices , and personal <br /> protective equipment required for my work . <br /> The hazards of any chemicals to which I may be exposed <br /> and my right to information contained on material <br /> safety data sheets for those chemicals , and how to <br /> understand this information . <br /> My right to ask any questions , or provide any <br /> information to the employer on safety , either directly <br /> or anonymously , without any fear of reprisal . <br /> Disciplinary procedures the employer will use to <br /> enforce compliance with Codes of Safe Practices . <br /> I understand this training and agree to comply with the Code of Safe <br /> Practices for my work area . <br /> Employee Signature Date <br />