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a <br /> Y ...................r..................,...r..r....................,..•..•.•,..•r»..,........ ...... .. <br /> ii <br /> .rfn <br /> ............................ ....................-..................................... ....................... ............. ..... .......... ........ •............».......r:..,+........n:.::..:.:...r....... ::..:.::.:..::..:.:........ <br /> n ?nA: Former Trac,y MGP Project Safety Plan(PSI J <br /> 0/# <br /> Employee/Subcon-Itractor Training", Acknowledgement <br /> Name of Trainer: -f f <br /> Training Subject: <br /> Training materials used <br /> FIN <br /> Name of employee: Actl\4' <br /> Date of hire/assignment: <br /> I, hereby certify that I have received training as described above in the following areas: <br /> ® Names of personnel responsible for site safety and health. <br /> • Safety,health or other hazards at the site. <br /> • The proper use of personal protective equipment. <br /> • The potential occupational hazards in general in the work area and associated with my job assignment. <br /> • Work practices by which a worker can minimize risks from hazards. <br /> • Safe use of engineering controls and equipment on the site. <br /> • Acute effects of compounds on the site. <br /> • Decontamination procedures. <br /> • General safety requirements indicate the safe work conditions,safe work practices and personal protective equipment <br /> required for my work. <br /> • The hazards of any chemicals to which I may be exposed and my right to information contained on material safety data <br /> sheets for those chemicals,and how to understand this information. <br /> • Ivry right to ask questions,or provide any information to the employer on safety either directly or anonymously without <br /> any fear of reprisal. <br /> • Disciplinary procedures the employer will use to enforce compliance with general safety requirements. <br /> I understand this training and agree to comply with general safety requirements for my work area. <br /> Llkk <br /> Employee Signature Date <br /> ....... : ::... :,n, n.:,:..n...::... {//.r..:..:.::........rr.:n.:... ......:/........... ...:...::.....:........./.................:..». ................:...:...:............../...::l........:.::Ar::�:�:hl:•�i:; <br /> ..r..,r.w:,..:.....: ..+::. ..�:,...n..:rr:....,..n.....,:................n.,....,:.,..../.,.:!...r+...rn.......,..�/...:..............n./»...............:.................../.:...:.:.::.:.:.:.....:�......r....n..........,?�.../.::.....................................:..,.......f.....l,r:.............:..... <br /> 37 <br />