SOP 511.34-att-3: Hazard Communication Training Acknowledgement Form

# SOP 511.34 Attachment 3 10/30/17 WORK AREA-SPECIFIC

HAZARD COMMUNICATION TRAINING ACKNOWLEDGEMENT FORM

I have been made aware of and have been trained in the uses and hazards associated with the chemicals to
which I am exposed. I have been provided with the necessary personal protection equipment and have
received training on the use and maintenance of this equipment. I understand my rights under the Employee
Hazardous Chemical Protection and Right to Know Act of 1988 (The Act) and the Occupational Safety and
Health Administration(OSHA) Hazard Communication, 29 CFR 1910.1200 [HCS 1994].

DATE: _______________________

NAME: ___________________________________

SUPERVISOR: _________________________________

SDS REVIEW

I CERTIFY THAT I REVIEWED THE FOLLOWING LISTED SAFETY DATA SHEETS [SDS] WITH MY
IMMEDIATE SUPERVISOR ON ___________________:

(DATE)

LIST OF SDSs REVIEWED: