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CERTIFICATION OF TRAINING Operator Trainee Name:______________________________________________ Date:_____________________________________________________________ o The above named trainee operator has been trained to operate the following types of powered industrial trucks, and has been evaluated pursuant to 29 CFR 1910.178 (l).
o The above named operator has received previous training and/or has experience of appropriate and sufficient types to waive additional training under 29CFR 1910.178 (l)(5). The operator has been evaluated to be competent in the operation of the following powered industrial trucks:
Trainer/Evaluator’s Signature______________________________________________________ Operator Trainee’s Signature______________________________________________________ REFRESHER TRAINING/EVALUATION SCHEDULED FOR:___________________________
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