Employee Training Record Revised Hazard Communication Standard Training

Facility Name: __________________________________________________ Date: ____________________________ Employee’s Name: ______________________________________________ I acknowledge and understand the training I received today. The training included: 1. Communication that changes have been made to the Hazard Communication

Standard. 2. Explanation of the labeling system changes, including the label elements such as:

a. Product identifier b. Signal word c. Pictogram d. Hazard statement(s) e. Precautionary statement(s)

3. How I might use the labels in the workplace and a general understanding of how the

elements work together on a label. 4. Explanation that the current Material Safety Data Sheets will be replaced by a new

Safety Data Sheet (SDS) format over time.

5. A review of the format of the SDS, the 16 sections on the SDS, how the SDS works with the label and a sample sheet.

6. Communication that workplace labeling will be changing between now and

June 1, 2016, when the new system will be in place.

7. Other: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

______________________________________________ Employee’s signature ______________________________________________ Date