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THE PAPE GROUP, INC. SU <br /> REQUIRED SAFETY TRAINING FOR NEW MEMBERS <br /> Member Name: AM lJ�t��� Hire/Transfer Date: cJU X2007 <br /> Job Title: SH?PW(7 I PECELVIA6 Company/Location: <br /> The member must be trained(or scheduled to be 0 <br /> trained) in the following topics prior to beginning work: <br /> Documentation of the training is required. <br /> Note: Do not take your training and docucation y A 3 O H <br /> responsibility lightly. Documenting than raining and/or .E " R <br /> instruction has taken place can at 11 y increase the ,a c� Completion <br /> company's liability if such training is inadequate for the 4 rA R Date <br /> job. a a <br /> • Introduction to members and tour of facility X X X X X 1 / -ZOO <br /> • Safety Attitude-Review Safety Policy#5.01 X X X X X _ -d <br /> • Review General Safety Provisions(IIPP)/074AB14 <br /> • Housekeeping X X X X X <br /> Clear aisle ways <br /> Clear exits <br /> Clean up of spills <br /> j <br /> Responsibility for your area <br /> • Violence Response Policy X X X X X <br /> • Review Job Specific Job Hazard Analysis/074AB15 <br /> • First Aid—location of kit,stretcher,blanket,eyewash, X X X X X <br /> and deluge showers. First aid trained personnel, <br /> • Emergency Action Plan—911 X X X X X <br /> Poster with store address <br /> Ambulance and Hospital Phone numbers <br /> Map of Store and exits,Meeting lace <br /> • How to report on the job accidents,incidents,and near X X X X X <br /> accidents <br /> • Have Member attend the first safety meeting held after X X X X X / <br /> date of employment /r <br /> I acknowledge I have received the above training,that I questioned what I did not understand,and that I agree to <br /> abide by prescribed work prw ice d rule of havior. <br /> Member Signature: Date: Ak <br /> This member has been tra' d in the above areas and I am confident in his or her knowledge of and competency in <br /> the areas requiring dem ns.1 <br /> ation of s work practices. <br /> Manager Signature: ��,� Date: `� �� <br />