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Construction Subcontractor Employee Training Matrix

Contractor Name:

Date:

Project Name:

LBNL Const. Mgr:

Instructions: Insert names of employees who will be working on site at LBNL in the space provided below. Place an "X" in the appropriate space to
indicate that the employee has been properly trained in the corresponding subject matter, and that supporting documentation is readily available. These
subject areas are those commonly encountered. Add or replace subject areas as needed.
Note 1: For those columns highlighted in YELLOW, submit corresponding documentation to EH&S (dllendahl@lbl.gov) for review & approval.

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I,

Print Name

Signature:

certify that the above named employees have been trained and are qualified to perform the
identified tasks as indicated above.

Date:

Crane Operations

Confined Space

Competent PersonExcavation, Scaffolding


Fall Protection

Qualified Person- LOTO

Qualified PersonElectrical
Qualified Electrical
Worker

Quantitative Respirator Fit


Test

Qualitative Respirator Fit


Test

Respirator Use Medical


Clearance

Respiratory Program

Silica /Lead / Asbestos


Awareness

GERT / Orientation

PPE

Scissor or Boom Lift

Traffic / Flaggers

Use of Fall Protection

Fire Extinguisher

Scaffold User

Employee Name

Ladder

Note 2: As validation, for those columns NOT in yellow, you will be required to provide documentation to EH&S as requested (dllendahl@lbl.gov).

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