Laserfiche WebLink
DISPENSING PROPANE SAFELY Check9APPIicable k� ❑ispenser Gperatnr <br />TRAINING CERTIFICATIONS TrainingCertifications ❑ Cylinder ExchangeSubb r <br />Customer Training Agreements and Training Instructions for Dispenser Operator's 1 Cylinder - <br />Exchange Personnel ! Customer's Employees/ Agents <br />SMET 2 00':.::I;:::: <br />This sheet must accompany SHEET 1 when more than three Employees f Aqents are trained. <br />Additional Employees 1 Agents Trained (Include Name, Signature, Date, and Tule) <br />CERTIFICATION. BY CUSTOM ER'S-M50NNEL'OF RECEIPT OF TRAIPHNG <br />BY SIGNING BELOW, EACH UNDERSIGNED EMPLOYEE I AGENT OF THE ABOVE NAMED CUSTOMER CERTIFIES THAT HE 1 SHE <br />HAS RECEIVED TRAINING FROM THE COMPANY INSTRUCTOR IN THE PROPER PROCEDURES TO USE, INSPECT, FILL, HANDLE, <br />CONNECT, OPERATE, STORE AND/OR TRANSPORT LP -GAG AND LP -GAS CONTAINERS, AND THAT HE / SHE UNDERSTANDS ALL <br />INSTRUCTICNS INCLUDING EMERGENCY AND FIRST AID PROCEDURES: <br />NAME SIGNATURE AND DATE <br />TITLE <br />4. 4 J �. �� vl Cts. moi_ <br />i <br />1 f• �/� I A Y j (I� <br />iY� <br />I iul�s � <br />s , <br />17 <br />7. <br />a. <br />9. <br />10. <br />71. <br />12. <br />13. <br />14- <br />15, <br />16, <br />17. <br />16. <br />20. <br />DISTRIBUTION- VV -I1TE or ORIGINAL — SUBURBAN YELLOW or COPY — CUSTOMER SHEET 2 of 2 17em �s:93" sr,F 5120 07 a <br />— <br />