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THE PAPE GROUP, INC. REQUIRED SAFETY TRAINING FOR NEW MEMBERS Member Name:; ,rQ,`O l ft1 -c,`°`- Hire/Transfer Date: Job Title: r,;Q lC Company/Location: The member must be trained(or scheduled to be o trained)in the following topics prior to beginning work. Documentation of the training is required. > Note: Do not take your training and documentation A 3 O H responsibility lightly. Documenting that training and/or p instruction has taken place can actually increase the ,9 ° a 6 Completion company's liability if such training is inadequate for the Q `n 0 Date job. G. c .. a w, • Introduction to members and tour of facility X X X X X • Safety Attitude-Review Safety Policy 9 5.01 X X X X -X • Review General Safety Provisions P /074AB14 • Housekeeping X X X X X ( vq- Clear aisle ways Clear exits Clean up of spills Responsibility for your area • Violence Response Policy X X X X X S �-- • Review Job Specific Job Hazard Analysis/074AB15 • First Aid-location of kit, stretcher,blanket,eyewash, X Xgoo X X X and delu showers. First aid trained personnel. 1 • Emergency Action Plan-911 X X X X X (( !7/ Poster with store address Ambulance and Hospital Phone numbers Map of Store and exits,Meeting lace • How to report on the job accidents, incidents,and near X X X X X rr R^6 4- accidents 11 dv • Have Member attend the first safety meeting held after X X X X X date of employment l �p I acknowledge I have received the above training,that I questioned what I did not understand,and that I agree to abide by prescribed work ractices and rules of behavior. Member Signature: LZ- Date: it This member has been trained in the above areas and I am confident in his or her knowledge of and competency in the areas requiring de o tration of safe w rk practices. J Manager Signature: Date: �{ ��