Training Attendance Form



Training Attendance Form

Asbestos Awareness and AT&T Floor Covering Procedure(s)

Date of Training: Trainer Company:

Trainer:

(Please Print Clearly) Name ID Number Phone Number

THIS TRAINING INCLUDED Drilling Cutting & Lifting (Coring) Both

|Persons Trained |ID Number or last 4 digits of Social Security|Company |

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I do hereby certify that each person listed above has received “Asbestos Awareness” training and completed the training program entitled “Asbestos Floor Covering Work Practices”. During “hands-on” training with non-asbestos floor coverings and mastic, each person demonstrated the ability to drill holes through or cut and remove intact pieces of floor covering in accordance with established procedures; “Drilling Holes in Asbestos-Containing Floors” and/or “Lifting Pieces of Asbestos-Containing Floor Covering.” In my judgment, these individuals are qualified to safely and correctly perform the procedure(s) as trained.

Signature Date

Submit completed training form by mail or fax to:

NEA Management Center Ph: 512-250-2600

10713 RR 620 North Fax: 512-250-2940

Suite 621

Austin, Texas 78726

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