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THE PAPE GROUP, INC. REQUIRED SAFETY TRAINING FOR NEW MEMBERS .#Aember Name: ► ted IL/le 11 Hire/Transfer Date: Job Title: —Sey i C,-e— Wy't t-.el Company/Location: The member must be trained (or scheduled to be a trained)in the following topics prior to beginning work. a t° Documentation of the training is required. > 4 Note. Do not take your training and documentation a A 3 0 u responsibility lightly. Documenting that training and/or �, instruction has taken place can actually Increase the ,a 0 ° Completion company's liability if such training is Inadequate for the `� �' Date job. a .. • Introduction to members and tour of facility X X X X X • Safety Attitude—Review Safety Policy#5.01 X X X X X • Review General Safety Provisions IIPP /074AB14 • Housekeeping X X X X X Clear aisle ways Clear exits Clean up of spills Responsibility for your area = • Violence Response Policy X X X X X • Review Job S ecific Job Hazard Anal i 074ABIS • First Aid—location of kit,stretcher,- lanket,eyewash, X X X X X and deluge sbowers. First aid trained personnel. �a aYt7 • Emergency Action Plan—911 X X X X X / 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 accidents • Have Member attend the first safety meeting held after XIX X X X date of employment �l"i7 N6 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 practi s an rules of behavior. Member Signature: 41Date: 'O� This member has been train in the above areas and I am onfident in his or her knowledge of and competency in the areas requiring de on r ion of safe worlapractices. Manager Signat e: Date: ��Q�