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THE PAPE GROUP, INC. q 4(40 <br /> REQUIRED SAFETY TRAINING FOR NEW MEMBERS <br /> Member Name: &,-,- � 2�yGQ GC I tC- Hire/Transfer Date: <br /> Job Title: S.t Company/Location; <br /> The member must be trained (or scheduled to be c <br /> trained)in the following topics prior to beginning work .3 <br /> Documentation of the training is required. <br /> Note: Do not take your training and documentation <br /> responsibility lightly. Documenting that training and/or a 3 <br /> instruction has taken place can actually increase the ,� ° a Completion <br /> company's liability if such training is inadequate for the 4 v' t "� w c Date <br /> job. a, a <br /> • Introduction to members and tour of facility X X X X X <br /> • Safety Attitude—Review Safety Policy# 5.01 X X X X X <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 /> 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 /> Ma of Store and exits,Meetinglace <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 <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 practices and rules of behavior. <br /> Member Signature.��1 1 G Date: 02 Y o-7 <br /> This member has been trained in the above areas and I am confident in his or her knowledge of and competency in <br /> the areas requiring demonstration of safe work practices. <br /> Manager Signature: Date: <br />