Safety Training Records Summary
You may print this form and have it signed in order
that you might use it where asked for documentation of training. There is
no requirement from the Chemistry Safety Office to do so, but there might be
(eventually) such a requirement from, for example, the Chemistry Shop as they
function as the key dispensary. For use as
an official record it must be signed by
your supervisor below.
(In the event that the supervisor is not available, another Dept administrator
or the safety officer may sign it.)
(The ID number shown here is
unique to this database and is not sensitive or
vulnerable.)
For ID number: 1567 Bayley, Bill
To report safety related
training obtained from other Purdue sources and submit it for addition to this
database, use this Report Other Safety
Training form. Contact
swihart@purdue.edu with questions.
| I certify that the person named above has
demonstrated satisfactory competence and understanding of the safety principles and
the understanding and use of PPE shown above (if any), and believe him/her to have an adequate grasp of
University
policies as well as State and Federal regulations pertaining to safety and environmental
protection. (The supervisor signature does not guarantee that there will never be mistakes, and no
liability is assumed by your signature that does not already exist. Demonstration of
understanding and competence is required by law.) |
| Supervisor (print name) |
|
| Supervisor signature |
|
|
Supervisor is
generally the Principal Investigator, i.e. the faculty member or director in
charge of hiring/firing, purchases. The supervisor may not be a person
without this authority, and may not be a part time or temporary employee. |
Faculty members and
others who report directly to the Department Head may sign as their own supervisor unless
they wish to obtain a Dean or Department Head signature. |