Lab Specific Training Form
Name ____________________________________
MTU ID M-__________________________
Position __________________________________
Supervisor __________________________
1. Topics Addressed by Laboratory Supervisor
a. Introduction to operation hazards present in labs, physical and/or chemical, types of hazards
encountered, and required work practices
b. Personal Protection Equipment (PPE)
c. General emergency procedures
d. Specific emergency procedures for labs with chemicals, and detection of chemical hazards
e. As appropriate for labs, MSDSonline, SOP(s), and/or CHP and labeling system
2. Training Provided (place mark next to room number/name indicating training for this space).
Dow Environmental Sciences and Engineering (8)
106/210A
D. Hand
826
N. Urban
850
J. Becker
107
R. Fritz
827
D. Minakata
850A
J. Becker
109
D. Perram
833
D. Hand
858
D. Watkins
110
D. Perram
835
J. Perlinger
860
J. Becker
810
D. Hand
838
J. Becker
901
P. Doskey
816
N. Urban
839
E. Seagren
902/903
P. Doskey
822
B. Dai
845
J. Perlinger
Minerals & Materials Engineering (12)
U003/A/B
T. Ahlborn
U112
T. Ahlborn
U210/A/B
T. Ahlborn
T. Ahlborn
108
T. Ahlborn
Grover C. Dillman (14)
SB
S. Vitton
B008B
B003
S. Vitton
B009/A/B
Z. You
109A
A. Swartz
Z. You
B010A
Z. You
110
B. Barkdoll
B005
K. Melo-Silva
B010B
S. Vitton
B006
R. Fritz
B011
R. Hodek
B008
K. Melo-Silva
B004/A
106
314/A
Z. You
K. Melo-Silva
Waste Management Resources Recovery (49)
C. Canoe
D. Hand
S. Bridge
D. Hand
Great Lakes Research Center (100)
104
J. Chadde
304
203
N. Urban
304A
M. Auer
J. Perlinger
Lab Supervisor Signature _________________________________
Date___________________
Employee Signature _____________________________________
Date___________________
Signatures acknowledge that the above topics have been adequately communicated
Revison 03-MAR-15