OSHA: Universal Precautions and

Fire and Electrical Safety Review

NAME:                                                                                  

SSN:                                     

DOB:                                     

ADDRESS:

 

STREET:                                                                              

 

STATE:                                    ZIP                                       

CITY:                                                                                    

 

PHONE:                                                                

I have met the annual review requirements in the following areas:

___ UNIVERSAL PRECAUTIONS        Date of Review:            

Review was performed by:                                          
                                                   Instructor’s Name                                                Date
                                                                       
                                                  Company/Institution
                                                                       
                                                   Instructor’s Signature

 

 ___ FIRE AND ELECTRICAL SAFETY      Date of Review:             

Review was performed by:                                          
                                                   Instructor’s Name                                                Date
                                                                                    
                                                  Company/Institution
                                                                                    
                                                  Instructor’s Signature

  

 

 

 

Employee’s Signature                                                                                              Date