Environmental Health & Safety

Safety Training Identification Work Sheet

 EMPLOYEE NAME:

SUPERVISOR:

DEPARTMENT/UNIT:

DATE:
Instructions: Supervisor reviews this list and make checks in the space to the left of each item if the employee meets any of the listed criteria. All questions refer to conditions that the employee will encounter working at OSU. When training is completed the date of the training can be placed in the right hand space. This form can be kept in the employee's file. 

Letter and numbers inside ( ) refer to programs available through EH&S; see list below. Items with * require annual training if program or hazard changes or new chemicals are used. 

Will This Employee Use:
 

 Date of training

  

 Date of training

Tractors or heavy ag equipment (T1)

    

Ladder or scaffold (L2)

    

Fork lift (F3)

    

Hand tools (Z1)

    

Power tools (P2 & P3)

    

Manlift, vehicle mounted work platform (Z1)

    

"Powder" actuated tools (Z2)*

    

Industrial truck (Z1)

    

Welding equipment (A1 & O3)

    

Video display terminal (W3)

    

Fume hoods (Z1)

    

Respirator (Z1)

    

Personnel-protective equipment (E2)

    

Fall arrest system (F1)

    

Herbicides or pesticides (P1,H4,W2,W4)*

    

Chemical or chemical compounds (H2)*

    

Eye wash or safety shower (Z1)

    

Mechanical power press (Z1)

    

Signs, signals, barricades (Z1)

    

Office equipment (O1)

    

Required to use fire extinguisher (F2)*

          

Will This Employee Perform Any of the Following Tasks:

 Lift, push, pull, or stand constantly (B1)

    

Perform maintenance at greenhouse (W4)

    

Tree trimming (Z2)

    

Respond to chemical spill (Z1)*

    

Enter a confined space (C2)*

    

Dig trenches or excavate (T2)

    

Food service work (Z1)

    

Perform first aid (In Job Description)(B3)*

    

Repair or install pitched roof (F1)

    

Transport, package, hazardous waste (H3)

    

Recharge storage batteries (Z1)

    

Service single or multi piece wheels (Z1)

    

Drive university vehicle (Z1)

    

Package or receive hazardous materials (H3)

    

Work with human blood/other body fluids (B3)*

    

Work around/with electricity (E1)

    

Scrape or sand painted surfaces (Z1)

    

Work on or maintain equipment that needs to be locked or tagged out to prevent accidental injury (L3)*

    

Diving (Z2)

    

Remove asbestos containing material (Z2)*

    

Will This Employee Work in an Area Containing any of the Following:

Asbestos (disturb when working) (A2,A3)               

    

Radioactive materials or radiation (R1)

    

Noise exceeding 80 dBA (Z1)*

    

Laboratory chemicals (L1)*

    

Hazardous chemicals (H2)*

    

Carcinogens (Z1)*