OSHA

OSHA EMPLOYEE ACKNOWLEDGEMENT OF RECEIPT OF TRAINING

New Hire Date:
It is policy that the first consideration of work shall be the protection of the safety and health ofall employees. A Hazard Communication Plan has been developed to ensure that all employees receive adequate information about the possible hazards that may result from the various materials used in our operations. This Hazard Communication Plan will be monitored by the Safety Program Administrator (SPA) who will be responsible for ensuring that all facets of the program are carried out, and that the program is effective.

OSHA requires that all employers provide employees with effective information and training onhazardous chemicals in their work area at the time of their initial assignment, and whenever a new chemical hazard the employees have not previously been trained about is introduced into their work area.
Due to this federal requirement, the Town provides such training as part of new employee orientation and we require that each new employee acknowledge receiving this training bycompleting the following:

I Acknowledge receipt of training on the Hazard Communication Standard (29 CFR 1910.1200). Specifically, I have been instructed on the hazardous chemicals present in the workplace, and Iunderstand the importance of protecting myself and my fellow workers from exposure to the various hazardous chemicals. I have been instructed and understand how to read and evaluatelabels and Safety Data Sheets and promise to do my part to make our organization a safe working environment.
I further understand that it is my responsibility to immediately inform my supervisor, manager,and/or department safety committee representative of any hazardous chemicals that I am not familiar with or do not know how to handle safely. In addition, it is my responsibility to immediately inform them whenever I observe a fellow employee handling a chemical in an unsafe manner.
Finally, I will do my part to insure that proper labels are maintained on all secondary containers that I utilize during the course of my work.

Date