San Juan College
Hazard Communication Plan
Employee Training Record for____________________________
(To be kept in workplace)
I have received training on the General Hazard Communication (HAZCOM)
Plan for San Juan College and site specific Hazard Communication
training for my work area.
I understand the following;
I must be trained regarding hazardous chemicals in my work area,
upon my initial assignment to the work area, whenever work procedures
are changed concerning the hazardous chemicals in the work area, or a
new chemical is introduced to work area.
It is my responsibility to understand the characteristics and
physical and health hazards associated with the hazardous chemicals in
the work area.
I understand that Material Safety Data Sheets will be made
available to me, upon request, for each chemical to which I may be
exposed in the work area.
I understand that I will have access to the San Juan College
Hazard Communication Plan for my work area.
received instruction on the General HAZCOM Plan and the site-specific
HAZCOM plan with attached chemical inventory for Room(s)___________ , Building___________ . I acknowledge that I have been
instructed in the following areas concerning the inventoried hazardous
chemicals to which I maybe exposed.
The chemical and common name of the inventoried hazardous
The location and operation, in the work area, involving hazardous
The location of the HAZCOM plan, MSDS book, and chemical
The proper and safe handling procedures for the inventoried
The physical and health hazards of the inventoried chemicals in
the work area.
Methods to protect myself and co-workers from exposure to
Emergency procedures for the work area.
An explanation of the chemical labeling system.
How to obtain and use hazard information.
Signature of Employee
Signature of Supervisor