MODULE 6: OTHERS
Accidents & Emergency Records
Date
NA
Area/Location
NA
Findings & Observation
NA
Actions Taken
NA
Remarks
NA
Personnel/Staff Training
Date Conducted
Course/Training Description
# of Personnel Trained
NA
NA
NA
I hereby certify that the above information are true and correct.
Done this , ________________in DAGUPAN CITY, PANGASINAN.
ALVIN B. CALAUNAN, REE, RME
__________________________________
Name/Signature of PCO
__________________________________
Name/Signature of CEO
SUBSCRIBED AND SWORN before me, a Notary Public, this day of
, affiants exhibiting to me their Community Tax Receipts:
Name
ID No.
Issued at
Issued on