Download Hazard Communication Program Environmental Health, Safety and Risk Management Department

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Stephen F. Austin State University
HAZARD COMMUNICATION ACT
TRAINING RECORD
The University requires documentation that all employees have been trained in the Hazard
Communication Act (HAZCOM). This requires attendance at both the General Hazcom training
course given during new employee orientation as well as Site-Specific training. The Supervisor
is responsible for insuring that Site-Specific training is provided to new employees and whenever
the potential for exposure to hazardous chemicals increases significantly or when new or
significant hazard information is received. In accordance with the General Safety Manual and
the University’s Hazard Communication Program, the individuals listed below have attended a
training session covering the provisions listed on the next page of this document.
DEPT.:________________ BUILDING/ROOM:_________________ DATE:_____
P.I.:___________________ INSTRUCTOR:__________________________________
(PRINT)
NAME (print clearly
(Last name, First Name, MI)
(Doe, John T.)
(PRINT)
SIGNATURE
Job Title
(John T. Doe)
(Director of ______)
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I certify that the topics listed on the next page were covered in this training session.
____________________________Signature of Instructor
Keep a copy and return the completed original form to the Environmental Health, Safety and Risk
Management Department.
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