Scribd
Upload
42 views3 pages

Meeting Voucher

rent voucher applying

Uploaded by

Salomão José langa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
42 views3 pages

Meeting Voucher

rent voucher applying

Uploaded by

Salomão José langa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

SAMPLE SAFETY TRAINING CERTIFICATION

Training Subject _______________________________ Date _________ Location _______________

Trainee Certification of Training

I have received on-the-job training on the subjects listed below. This training has provided me adequate
opportunity to ask questions and practice procedures to determine and correct skill deficiencies. I
understand that performing these procedures/practices safely is a condition of employment. I fully
intend to comply with all safety and operational requirements discussed. I understand that failure to
comply with these requirements may result in progressive discipline (or corrective actions) up to and
including termination.
_________________________ ______________________ ___________

Employee(s) Name(s) Signature(s) Date(s)

Subjects Taught

_______________________________ _________________________ _______________________

Trainer Certification of Initial Qualification

I have conducted orientation/on-the-job training to the employee(s) listed above. I have explained
related procedures, practices, and policies. Each employee was given the opportunity to ask questions
and practice procedures in the learning environment. Based on each student's performance, I have
determined that each employee has adequate knowledge, skills, and abilities and is initially qualified to
safely perform these procedures and/or practices.

_________________________ ______________________ ___________

Trainer Name(s) Signature(s) Date(s)

Supervisor Certification of Full Qualification

I observed/interviewed the above employee(s) on __________ date(s). Each employee has


demonstrated adequate knowledge, skills, and abilities and is fully qualified to safely perform all steps of
the procedures and/or practices in the work environment (at their workstation, worksite, etc.).

_________________________ ______________________ ___________

Supervisor Name Signature Date

Notice that supervisor certification is included as part of the training document. The supervisor
evaluates employee knowledge, skills, and abilities (KSAs) on the job. Including this statement will help
ensure employees are "fully qualified" and authorized to perform hazardous procedures and practices.

© Geigle Safety Group Inc. 2018 1


Training Subject ____________________ Date __________ Location _______________

Trainee Certification of Training

I have received on‐the‐job training on those subjects listed (see other side of this sheet): This
training has provided me adequate opportunity to ask questions and practice procedures to
determine and correct skill deficiencies. I understand that performing these
procedures/practices safely is a condition of employment. I fully intend to comply with all
safety and operational requirements discussed. I understand that failure to comply with these
requirements may result in progressive discipline (or corrective actions) up to and including
termination.

Employee Name Signature Date

_________________________ __________________________ ________________

_________________________ __________________________ ________________

_________________________ __________________________ ________________

_________________________ __________________________ ________________

_________________________ __________________________ ________________

Trainer Certification of Competency

I have conducted orientation/on‐the‐job training to each employee listed above. I have


explained related procedures, practices and policies. Each employee was given opportunity to
ask questions and practice procedures in the learning environment. Based on each student's
performance, I have determined that each employee trained has adequate knowledge and skills
to safely perform these procedures/practices.

_________________________ __________________________ ________________


Trainer Name Signature Date

Supervisor Certification of Competency

I observed/interviewed the above employees on __________ date(s). Each employee has


demonstrated adequate knowledge and skills to safely perform all steps of the
procedures/practices in the work environment (at their workstation, worksite, etc.).

_________________________ __________________________ ________________


Trainer Name Signature Date
The following information was discussed with students: (check all covered subjects)

Overview of the hazard communication program ‐ purpose of the program


Discussion of the hazards of chemicals to which students will be exposed
Primary, secondary, portable, and stationary process container labeling requirements
Discussion of the 16 sections of the SDS and their location
Emergency and Spill procedures
First aid procedures
Symptoms of overexposure
Use/care of required personal protective equipment used with the above chemicals
Employee accountability

The following practice/performance exercises were conducted:

Spill procedures
Emergency procedures
Personal protective equipment use

The following written test was administered: (Or "Each student was asked the following questions:")
(Keep these tests as attachments to the safety training plan and merely reference it here to keep this
document on one sheet of paper)

1. What are the labeling requirements of a secondary container? (name of chemical. and hazard
warning)

2. When does a container change from a portable to secondary container? (when employee loses
control)

3. What are the symptoms of overexposure to _____? (stinging eyes)

4. Where is the "Right to Know" station (or SDS station) located? (in the production plant)

5. What PPE is required when exposed to _____? (short answer)

6. How do you clean the PPE used with _____? (short answer)

7. What are the emergency procedures for overexposure to _____? (short answer)

8. Describe spill procedures for _____. (short answer)

9. When should you report any injury to your supervisor? (immediately)

10. What are the consequences if you do not follow safe procedures with this chemical? (injury, illness,
discipline)

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy