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Certification <br />• . <br />Safety <br />Training <br />Employee's Full Name:, r -!2,• Nur 4 'R;_ SSN�-��- <br />Location of Training: Qtt go n , i 9Ho- iC 'G <br />Date Training Provided: % //_/ 0 5 - Total Time Spent Training: 5 <br />Type of Training Provided: <br />(check all that apply) <br />❑ Classroom <br />❑ Video <br />,X Written Plan, Policy, or Procedure <br />❑ Safety Newsletter for: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec <br />❑ Other <br />Title of Training: In , 0/, <br />I hereby acknowledge that the above mentioned safety training class and /or material has <br />been provided to me. If the material is written I hereby acknowledge I have received my <br />own copy, read it, and understood the safety material presented. <br />Employee's Signature: Vi r u �,�� �o rR , Date: IQ —/ 9-0 <br />5 <br />Instructor Certification <br />I certify that I presented, provided, and/or prepared the above noted safety material <br />and/or information to the above mentioned employee. <br />Instructor Name: {'B /Gr�7 Signature: SN. �Q fC tG Date: <br />Pleas* provided this completed form to your supervisor/foreman so he/she may promptly return it to the Elon Golf <br />Construction office for review, signature, and filing. <br />"SAFETY is what we do for our employees... not what we do to them!" <br />