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y,�. = THE PAPE GROUP, INC. �Co� REQUIRED SAFETY TRAINING FOR NEW MEMBERS Member Name: FY'G, t- C-RV D6S _Hire/Transfer Date: Job Title: W-e C-L c--: r_ Company/Location: The member must be trained (or scheduled to be trained)in the following topics prior to beginning work. c0 d Documentation of the training is required. > Note: Do not take your training and documentation y A 3C responsibility lightly. Documenting that training and/or .Fi L Kn •+ instruction has taken place can actually increase the n h vU Completion company's liability if such training is inadequate for the `" � Date job. A, a • Introduction to members and tour of facility X X X X Ix -d • Safety Attitude-Review Safety Policy#5.01 X X X X Xo6.2-z-X-ol • Review General Safety Provisions IIPP)/074AB14 • Housekeeping X X X X X /-2-/.X— Clear aisle ways Clear exits Clean up of spills Responsibility for your area • Violence Response Policy X X X X X • Review Job Specific Job Hazard Anal 074AB15 • First Aid-location of kit,stretcher, lanket, eyewash, X X X X X and deluge showers. First aid trained personnel. 1 • 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 X X X X X date of employment 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 practices and rules of behavior. Member Signature: Date: This member has been trained ' h bove areas nd I am confident in his or her knowledge of and competency in the areas requiring dem nstr d of sa work racctices. Manager Signatur Date: