Position: ____________________________________ Trainer: ____________
I acknowledge that I have been trained in the SAFETY AND HEALTH areas checked below, and I agree to follow all SIGN DESIGN & FABRICATION, INC. Safety and Health Rules, Policies and Procedures.
_____Safety and Health Program
My right to ask questions, or report any safety hazards, either directly or anonymously without any fear of reprisal.
The location of SIGN DESIGN & FABRICATION, INC. safety bulletins and required safety postings (i.e., summary of occupational injuries and illnesses, and Safety and Health Protection Poster).
Disciplinary procedures that may be used to ensure compliance with safe work practices.
Reporting safety concerns.
Accessing the department safety committee.
_____Incident Reporting & Reporting Occupational Injuries and Illnesses
_____ Hazard Communication
The potential occupational hazards in the work area associated with my job assignment.
The safe work practices and personal protective equipment required for my job title.
The location and availability of MSDS’s.
The hazards of any chemicals to which I may be exposed, and my right to the information contained on Material Safety Data Sheets (MSDS’s) for those Chemicals.
_____Hazardous Material Spill Response
_____Bloodborne Pathogen Response
_____Personal Protective Equipment
_____Employee(s) Safety Manual
_____Machinery Tag-Out Program