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0 9 ��qdc � <br />Stockton Surgery Center <br />Facilities & Environment Manual <br />Hazard Communication Standard Training Form <br />I acknowledge being trained and understanding the Hazard Communication program. The training <br />provided to me included the following: <br />■ Location and availability of the Hazard Communication Program <br />■ Operations in my work where potentially hazardous chemicals are present <br />■ Location of the inventory list of chemicals used at the facility <br />■ Location and availability of the Material Safety Data Sheets (MEDS) <br />■ Explanation of physical and health hazards on the MSDS and how to read the MSDS <br />• Explanation of detecting a hazardous substance release <br />■ Measures to be taken for protection against a substance consistent with the MSDS <br />• Explanation of container labeling requirements <br />■ Steps to be taken to handle leaks, spills, and disposal consistent with the MSDS <br />■ My right to obtain additional information upon request from the facility <br />Signature <br />Date <br />Copy to be placed in Personnel File <br />.Effective Date: 3/5/2009 8:34 AM6/1/2009 <br />Revised Date: <br />Hazardous Materials Waste Management-MASTER.doc <br />