Employee Safety And Health Record Page 2
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2EMPLOYEE SAFETY AND HEALTH RECORD
III. RECORD OF SAFETY, FIRE PREVENTION, ENVIRONMENTAL, AND HEALTH TRAINING AND JOB SAFETY TRAINING
(By signing this form the employee acknowledges full understanding of the training received)
CERTIFICATION OF
SIGNATURE OF
TYPE TRAINING
INTERVAL
DATE
SUPERVISOR/TRAINER
EMPLOYEE
IV. REMARKS
FOR OFFICIAL USE ONLY
AUTHORITY:
10 U.S.C., Chapter 40; 37 U.S.C., Chapter 9, EO 9397, November 1943
PRINCIPAL PURPOSES:
For documentation of occupational safety, fire protection, environmental and health training.
ROUTINE USES:
Use to create a record of training and to retrieve record of safety, fire protection, and health training.
AF FORM 55, 20130710
(Reverse)
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