EMPLOYEE ACKNOWLEDGEMENT OF RECEIPT OF TRAINING

IN UNDERSTANDING

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GENERAL GUIDELINES FOR ELECTRICAL SAFETY

I, acknowledge receipt of training with regard to the general guidelines for Electrical Safety set forth by . Specifically, I have read through the safety guidelines and understand that it is my responsibility to recognize when electrical precautions must be employed to protect myself and others around me. I further understand that if I do not know how to safely manage an electrical hazard, I must not proceed until I have either been properly trained or received assistance. Finally, I understand the role I must play in inspecting for electrical hazards, and that inspections are to be performed prior to work.

Training was received on this day of , Year

Employee's Signature Date

Trainer's Signature Date