Chemical Safety Training

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In compliance with the Yuma County Hazard Communications Program, any employee who is to work with hazardous chemicals is to receive safety training prior to working with those chemicals. This form serves to document that the employee below has received training in the following categories:

Topics Covered
____ Interpreting labels and Material Safety Data Sheets
____ Identity and location of hazardous chemicals in the employee’s work area
____ Acute and chronic effects of exposure to hazardous chemicals in work area
____ Handling and storage of hazardous chemicals
____ Selection, care and use of personal protective equipment and clothing
____ First aid treatment of those exposed to hazardous chemicals
____ Spill cleanup procedures
____ Disposal of hazardous chemicals
____ Location of fire extinguishers and eyewash/shower stations

Categories of Hazardous Chemicals
____ Flammables        ____ Carcinogens
____ Corrosives          ____ Irritants
____ Poisons/Toxins    ____ Other: ______________________
____ Reactives

_________ _____________________ _______________________
Date Employee Instructor

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