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V <br /> THE PAPE GROUP, INC. slq& <br /> REQUIRED SAFETY TRAINING FOR NEW MEMBERS <br /> Member Name: TD(m, Hire/Transfer Date: / ' - rQ / <br /> Job Title: ACompany/Location: O l� <br /> The member must be trained(or scheduled to be <br /> trained)in the following topics prior to beginning work. <br /> d <br /> Documentation of the training is required. <br /> Note: Do not take your training and documentation <br /> responsibility lightly. Documenting that training and/or <br /> instruction has taken place can actually increase the Completion <br /> company's liability if such training is inadequate for the Date <br /> job. ;6 = <br /> • Introduction to members and tour of facility X X X X X �Z-D <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 —l7 <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/074ABIS <br /> • First Aid—location of kit,stretcher,blanket, eyewash, X X X X X <br /> and deluge showers. First aid trained personnel. _0 <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 Z D7 <br /> I acknowledge I have ree ' ed the above training,that I questioned what I did not understand,and that I agree to <br /> abide by prescribed wo p actices an(yres of behavior. <br /> Member Signature: 0Date: "© <br /> This member has been trained i the above areas and I am confident in his or her knowledge of and competency in <br /> the areas requiring demonstration of saf o practi s. <br /> Date: <br /> Manager Signature: <br />