b'Payroll FormsPayroll Change Notice Bestseller Workplace SafetyPayroll/Status Change NoticeDate_____________________ I.D. #___________________ Social Security # ____________________________ Please PrintPayroll______________________________________ Brought to you by ComplyRightRouting Name_______________________________ Title___________________________ Classification___________________ Effective Date of Change _____________ New Hire Change Separation//Street Address_______________________________________________________________________________ Employee Name_____________________________________________________________________________________________LastFirstMiddleCity/State/ZIP__________________________________________________Phone ( )_______________ Social Security # _____________________________Employee/Payroll # ____________Dept. _____________________________Division_________________________Department_____________________Shift________________________ Payroll/Status Change NoticeAddress____________________________________________________________________________________________________StreetCityStateZIP CodeCheck appropriate box: Please Print Telephone #_______________________________ Date of Birth (for administrative use only) __________________/ /() Enter on PayrollTransfer to:(Department) _______________________________ Routing Payroll/ Status:Full-Time___________________ Part-Time TemporaryOther______________________What It Is: ___________________Part-Time Full-Time Temporary Effective Date of Change _____________New Hire ExemptNon-ExemptHourlyW-4 Attached? Yes NoJ ob Title_______________________________ChangeSeparation / Change RateChange Shift to:__________________________________________ Employee Name_____________________________________________________________________________________________Last Change(s) for Current Employee Middle Remove from PayrollChange Withholding Rate(complete new W-4 form) D TypeFirstFromStateToZIP Code Comments A full line of safety solutionsincluding posters and training programsSocial Security # _____________________________Employee/Payroll # ____________Dept. _____________________________Address Change _____________________________________________________________________________________________ FLSA ReclassificationChange Title to: ______________________________________emotion _____________________________________________________________________________________________Address____________________________________________________________________________________________________ Department _____________________________________________________________________________________________Payroll Change Notice (Date of return to work) ________________________________ Status:Full-TimeStreet imeReclassification CityOther______________________to help businesses meet Occupational Safety and Health Act (OSHA) Telephone # () FLSA____________________________________________________________________________________________________________________________ Date of Birth (for administrative use only) __________________/ / 401(k)/403(b) Contribution _____________________________________________________________________________________________Part-T Insurance Full-Time TemporaryPart-Time TemporaryEligibility _____________________________________________________________________________________________ Job TitleNon-Exempt HourlyW-4 Attached? Yes No________________________________________________________________ Job Title _______________________________Exempt_____________________________________________________________________________________________ Date________________ I.D. #______________ Social Security #____________________ Changeof Insurance _____________________________________________________________________________________________ requirements and protect employees from workplace hazards.________________________________________________________________ Change(s) for Current Employee _____________________________________________________________________________________________ LayoffName_______________________ Title___________________ Classification_____________ TypeLengthof S From _____________________________________________________________________________________________ervice Increase ToComments Merit Increase_____________________________________________________________________________________________Street Address____________________________________________________________Address Change _____________________________________________________________________________________________ End of Introductory Period _____________________________________________________________________________________________City/State/ZIP______________________________________ Phone ( )____________ D emotion _____________________________________________________________________________________________Promotion _____________________________________________________________________________________________ Department _____________________________________________________________________________________________ Reevaluation of Current Job _____________________________________________________________________________________________Division___________________ Department______________Shift__________________FLSAReclassification _____________________________________________________________________________________________Rehire _____________________________________________________________________________________________Check appropriate box:Transfer to: (Department)_________________________ 401(k)/403(b) Contribution _____________________________________________________________________________________________ Who Its For:Resignation _____________________________________________________________________________________________ RetirementInsurance Eligibility _____________________________________________________________________________________________ Retirement _____________________________________________________________________________________________ Enter on PayrollJob Title _____________________________________________________________________________________________Salary/Wage _____________________________________________________________________________________________ Change RateChange Shift to:___________________________________ Change of Insurance _____________________________________________________________________________________________ Layoff Separation __________________________________________________________________________________________________________________________________________________________________________________________ Shift Change _____________________________________________________________________________________________ Remove from PayrollChange Withholding Rate (complete new W-4 form) New EmployeeLengthof Service Increase _____________________________________________________________________________________________Change Title to:________________________________Merit Increase Transfer _____________________________________________________________________________________________ FLSA Reclassification: Full-TimePart-TimeTemporary End of Introductory Period _____________________________________________________________________________________________ Everyone! By law, employers must comply with OSHA safety regulationsUnion Scale __________________________________________________________________________________________________________________________________________________________________________________________ Change Status to PromotionOther ___________________________________________________________________________________________________________ Leave of Absence:Paid?YesNoReturn (Date of return to work)____________________R eevaluation of Current Job Leave of Absence Begin Leave______________Return from Leave ________________ / / / / Address/Information Change ________________________________________________________________ Rehire _____________________________________________________________________________________________ (Including Pregnancy) to prevent work-related injuries and illnesses. EducationalPersonal Family/Medical Leave____________________________________________________________________________________________________________________________________________Resignation _____________________________________________________________________________________________ Short-Term DisabilityLong-Term Disability Other _________________________________________________________________________________________________ etirement _____________________________________________________________________________________________ R Retirement / / / / / / OtherSalary/Wage Separation Separation Date _________________Last Day Worked _________________Last Day Paid ____________________________________________________________________________________________________________ S eparationVoluntary Separation Involuntary SeparationNotice of COBRA Rights Provided on_____________/ /Date Effective Hour _______________________________________________________________________________________________________________________________________________________________________________________S hift Change _____________________________________________________________________________________________ Election of COBRA YesNo Start Date of Coverage_______________/ /Old Rate______________ Per____________T ransfer _____________________________________________________________________________________________ If yes, describe type of coverage elected:_____________________________________________________________________________New Rate _______________________________________________________________________________________U nion Scale _____________________________________________________________________________________________ Date of Last Payroll Change PerOther ______________Additional Comments ________________________________________________________________________________________________Why Sell It: _______________________________________________________________________________________Begin Leave ____________________________________________________________________________________________________________________________________________Leave of Absence______________ Return from Leave________________/ / / /_______________________________________________________________________________________EducationalEmployee Signature(Optional)_________________________________________________________________________ Date ________________Reason for Payroll Change PersonalFamily/Medical Leave(Including Pregnancy) / /Name and Title Merit IncreaseSee Performance AppraisalNew EmployeeShort-Term Disability Long-Term Disability Other______________________________ Date ___________________________________________ ________________ Supervisor/Designated Manager Signature_____________________________________________________________/ / PromotionOther__________________________________________ ________________ Separation Separation Date _________________Last Day Workeds o p / / Notice of COBR Name and Title / / Date ________________ Provide essential safety posters and programs, to help businesses meet / / / /_________________ Last Day Paidd_______________ / /Human Resources/Payroll Manager Signature ___________________________________________________________ ___________________________Voluntary SeparationInvoluntary Separationan NAe and Title ver, itReason for Termination: (Please complete Exit Interview form.) Th d n ARights Provided on_____________/ /am VoluntaryT Tpheicsi pfpirco fdaucctctstoisrdseesrsrivgincnceesd.Ttoh pe r rionvfiodrem aactciouounrnra itseparnodv aiaiduetdh owriittahat ititvhveeiunnfdoremrstatatinodni.n Hg tt. hYaot ua nayr e p uerrgsgsoednd toorceonntistuyl l itit navno alavttorney concerning your particularss Election of COBRA YesNo Start Date of Cov grnmeadat titoanbility to use this product. You are urged to consult an attorney concerning your particular situation and any specific questions or concerns you may have. is i i g ta t y ee r s e DischargedLaid OffOther owever, it is not a substitute for leedg ainl a a cdreveaiaictein agn, dp rdoodeus cninontgtgporro dviisdster ilbegugtatailn ogp tinhniiioso nprsrso o odnu acnt yis or siee s rpvrioces u. cTtise d dieness fio erage ro vpirdoev aiadcecu rratteh et hd e auu ntdheorrsittaantnidven informattio nn.Hoowwe ore ntt i t iy snnovto al v seudb isinti tcurtetea tfoioinrg gl,e pgpraol daududvciiicnegaonr d d disotreisb nuotitn pgr othviisd epep rleoegdaulc ot pisisin nniooootnt slsli aobnl ea fnfoyrs sapneyc idfaiaicm faacgtessorh sise rpvriocdeus.c Tt hise d iensfiogrnmedat itoo np riso vpridoev iadcecdu rwatiteh a tnhdeauuntdheorrsittaantidvein ign tfohramt aantiyo npe. rHsoown eovr eern, itti tiysninovto al vseudb sinti tcuretea tfoinr gl,e pgraol daudvciicnegaonrd d disoterisb nuotitn pgr othviids ep rleogdaulc ot pisi nniootn lsi aobnl ea nfoyr s apneyc idfaicm faacgtess h _______________ n th aa np onor in d / w/on/ Remarks: arising out of the use or inability to use this product. You are urged to consult an attorney concerning your particular situation and any specific questions or concerns you may have. If yes, describe type of coverage elected:_____________________________________________________________________________ I federal and state requirements, while safeguarding employees.n arispionrgt aonuttnoof tteh:e eT uhsiesoisraipnproved for use by the purchaser only. This form may not be shared publicly or with third parties.not liable for any damages arising out of the use or inability to use this produc 2016 ComplyRight, Inc. am____________________________________________________________________ A2168 Two easy ways to reorder: hrdirect.com800-999-9111Important note: This is approved for use by the purchaser only. This form may not be shared publicly or with third parties.____________________________________________________________________ Additional Comments________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Employee Signature(Optional)_________________________________________________________________________________________/ /Date ____________________________________________________________________________________ Standard, 3-PartName and Title ________________ StandardSubmitted By__________________ Title____________________ Date _____________ Supervisor/Designated Manager Signature_____________________________________________________________/ // /Approved By___________________ T fTitle____________________ r g e h gDate_____________ Carbonless T T Name and Title Date ________________ When to Sell:/ /________________/ /Human Resources/Payroll Manager Signature ___________________________________________________________Date ________________Name and Titlefahcitssporr osdeurvctic iess d. eTshigen inedfo trom partoiovnid iesapcrcouvriadteed a wndit ahu tthheo urintadteirvset ainnfdoirnmg athtioatn a. nHyo pweervsoern,iot ri se nntoitt yaisnuvbosltviteud tein f ocrre laegtianl ga,d pvriocde uacnind gd oore sd nisotrt ipbruotvinidgetlheigsa pl roopdiunciot nissnoontalinayb lsep feocir faicn yo orh sise rpvriocdeus.c Tt hise d iensfiogrnmedat itoo np riso vpridoev iadcecdu rwatiteh a tnhdeauuntdheorrsittaantidvein ign tfohramt aantiyo npe. Hrsoown eovr eern, itti tiysninovto al vseudb sinti tcuretea tfoinr gl,e pgraol daudvciicnegaonrd d disoterisb nuotitn pgr othviids ep rleogdaulc ot pisi nniootn lsi aobnl ea nfoyr s apneyc idfaicm faacgtessThis product is designed to provide acurate and authoritative ainndfoiar atiaotn a. nHyo pweernsosult an ataisnuvbosltvoendc einrn ci relea ytionugr,ppraordtiucucilnagrsoirtu daitsitornib auntidn ga nthy issp percoifdicu qctu iestions or concernso arising out of the use or inability to use this product. You are urged to consult an attorney concerning your particular situation and any specific questions or concerns you may have.daacmtsa ogre ss earrviisciensg.oTuhte o ifn tfhoer musaet ioorninisa pbriloitvyid teod u wseit thh tish pe ruondduecrts.t Younm turged to co vern,iotr i se nntoittoyrney c itute forn gal advice and does not provide legal opinionssnoont a lniayb slep efocri faicn ye legal opinions on any specific faacgtessdamages arising out of the use or inability to use this product. You are urged to consult an at I orney concerning your particular situation and any specific questions or concernsThis product is designed to provpir toov iudseed t hwiist ph rtohdeu ucnt.d Yerorsut aanrde iunrgg etdhd a atto a cnoyn psuerlts oannoatrt t eonrtntnietyyyyicnovnoclevrendi ningcyroeuart ipnagr, t picruodldlaur c situation andanot provid pipicr oqudueuesctti oisn ns ootrl ciaobnlcee fronrs a ynoyu d mamay have.ym arr i sseieinrvgvi icocoueuest.oTf hteh ei n nufsoer mora itnioanb iilsi ty de accurate and authoritative information. However, it is not a substitute for legal adviiiicncegaonr d dd disotreisb uantniyn gsg ptehciisfoup moratya nht anvoe.te: This is approved for use by the purchaser only. This form may not be shared publicly or with third parties. Important note: This is approved for use by the purchaser only. This form may not be shared publicly or with third parties.Important note: This is approved for use by the purchaser only. This form may not be shared publicly or with third parties.2016 ComplyRight, Inc.A2168 Two easy ways to reorder: hrdirect.com800-999-9111 Year-round. General safety posters are required in nearly every state. Compact 3-Part Carbonless You can also reach out to customers with warehouses about the forklift safety bundle.Payroll Status Change NoticeDocument all job and salary changes, including reclassi\x1f cation, transfers and promotions. List new hire information, leave of absence and separation data. Ensure employee \x1f les have updated, current payroll records. Understanding GHS HazardCarbonless form instantly provides copies for the employee,Communication Labelingsupervisor and HRs personnel \x1f les Includes a ComplyRight guide to help you documentCHOKING Follow these steps for adults and children over 8 years of age who have an obstructed airway.OSHA has updated the requirements for labeling of hazardous chemicals to Use common sense with any serious injury. Call 911 (or other emergency number) for assistance right away. Know the type of injury job and salary changes the right way and the exact location of the victim. Avoid moving the victim whenever possible; bring help to him/her instead. Know where AEDs and first aid kits are kept. This information does not take the place of CPR (Cardiopulmonary Resuscitation) training. For emergency first aid and CPR training, contact your Human Resources Department, local Red Cross or American Heart Association. align with the Globally Harmonized System (GHS). As of June 1, 2015, all labels will be required to have pictograms, a signal word, hazard and precautionary statements, the product identi er, and supplier identi cation. A sample revised Payroll Change Notice1 Determine Choking is recognizable when the victim CANNOT breathe, coughForklift Safetylabel, including the required label elements, is shown at left. Supplemental or talkno air is moving through the persons throat. Ask, Are youinformation can also be provided on the label as needed.A2170Standard, 3-Part Carbonless if the victimchoking? If the victim can breathe, cough or speak, stand by, butLabels must contain the following required elements:is choking: do not interfere. Label con guration may vary from this example.A2173Compact, 3-Part CarbonlessProduct Identifier Hazzard Pictogramsstomach (above the waist and well below the breastbone), 0 information assigned to a hazard class and category. talking, coughing waist above the navel. Make a fist, with thumb side against the1Steps to SafetyPrice per pkg/50. Standard: 8 x 11, Compact: 5 x 8. 2 If the victim is NOTStand behind the victim and wrap your arms around the personsLists the name or number used for the hazardous chemical.Conveys health, physical and environmental hazard It provides a unique means by which a reader can identify the chemical. Includes a symbol plus other graphic elements, such as or breathing: and grasp your fist with your other hand. a border, background pattern, or color. There are eight mandatory OSHA pictograms designated under OSHAs Payroll/Status Change NoticeSupplier Identification Hazard Communication Standard for application toLi 2. Loading & UnloadingA21683-Part Carbonless 3 Pull your fistIf this should happen, call 911 immediately. 1. Training Brakes shall be set and wheel blocks shall be tilt to stabilize the load shall be used. a hazard category.Use quick upward and inward thrusts. Repeat as necessary, untilsts the name, address and telephone number of the3. Batteries chemical manufacturer, importer, or other responsible party.toward thethe obstruction is cleared or the victim becomes unconscious.in place to prevent movement of trucks, trailers, secured before they are driven over, with their& Fuel TanksDockboard or bridgeplates, shall be properly Signal WordsA2172Standardvictims stomach: The employer shall certify that eachor railroad cars while loading or unloading. rated capacity never exceeded. Only loads withinFuel tanks shall not be filled whileoperator has been trained and evaluatedThe flooring of trucks, trailers, and railroad carsIndicates the relative level of severity of the hazard the rated capacity of the truck shall be handled.as required by 29 CFR 1910.178(1). shall be checked for breaks and weakness beforeand alerts the reader to a potential hazard on the label. When stacking or tiering, only enough backwardthe engine is running and spillage shall Precautionary Statements be avoided.The certification shall include the namethey are driven onto. Danger is used for the more severe hazards, while Price per pkg/50. Standard: 8" x 11", Compact: 5" x 8".4 If the victim and the other hand under the chin and gently tilt the he of the operator, the date of the training,warning is used for the less severe. These are the Carefully lay the victim on his or her back, protecting the head andDescribes recommended measures that should be taken toTrucks in need of repairs to the the date of the evaluation, and the neck. Open the airway by placing one hand on the victims forehead person(s) performing only two signal words a reader will see on a label.identityofthe minimize or prevent adverse effects resulting from exposureelectrical system shall have the battery becomes the training or evaluation. disconnected prior to such repairs.ad backto a hazardous chemical or improper storage or handling.(head tilt-chin lift). Keep the mouth open. Check for obstructionunconscious: in the airway. If you see an obstruction, reach in and take it out.AlwaysHazard Statements 4. Routine If you dont see anything, immediately attempt chest compressions. Supplemental InformationRemember ChecksLists standard OSHA phrases assigned to a hazard classLists any other information provided by the labeler such Locate the middle of the breastbone by drawing an imaginary lineand category that describe the nature of the hazard. as the physical state of the chemical or directions for use.elow that Industrial trucks shall be examined between the nipples. Place the heel of one hand just b Stunt driving and horseplay shall before being placed in service, and not be permitted.18 Employee Management Forms 5 Begin chestline and then place the heel of the second hand on top of the firstshall be kept clear Health shall not be placed in service if theExclamation19so the hands are overlapped. Straighten your arms, loc Fire bowsaccess to stairways, andexamination shows any conditionk el aisles,and lean over so your shoulders are in line above your hands. adversely affecting the safety of the fire equipmentcompressions: Workplace Safety & Training Tools Flame MarkUsing the heels of both hands, firmly push straight downvehicle. Such examination shall be made approximately 2 inches but no more than 2.4 inches on the chest.HCS PictogramsHazard at least daily. Defects when found shall Running over loose objects on the roadway surface shall be avoided.Release pressure completely between pushes, keeping your haandsbe immediately reported and corrected.on the victims chest at all times. Allow the chest to return to itsand HazardsCarcinogenFlammablesIrritantnormal position completely after each compression. Avoid leaning (skin and eye)10. Keep MutagenicityPyrophoricsSkin Sensitizeron the chest between compressions. Count the number of compressions by saying one and two and threePush hard Hazard Communication Reproductive Toxicity 5. TravelingAcute ToxicityTrucks CleanRespiratory SensitizerSelf-HeatingNarcotic Effectsand push fast (rate of 100 to 120 compressions a minute). Standard PictogramsEmits Flammable GasRespiratory Tract IrritantAll traffic regulations shall be observed,Industrial ue per fshall ibekept in ompres sions Target Organ ToxicitySelf-ReactivesHazardous to Ozone Layerincluding authorized plant speed limits.If you are not trained in CPR or are uncomfortable with your ability to provide rescue breaths, skip steps 6 and 7 and contintrucksormngchest ca cleanAspiration ToxicityOrganic Peroxides (Non-Mandatory)at a rate of 100 to 120 compressions a minute until an AED arrives and is ready for use, the victim begins to move or EMS personnel take over care of the victim.A safe distance shall be maintained condition, free of lint, excess oil, and grease. Noncombustible agents shouldu ne 1, 2015, the Hazardapproximately three truck lengths from As of JOpen the airway by placing one hand on the vict be used for cleaning trucks. (Includesthe truck ahead, and the truck shall be ims forehead andCommunication Standard (HCS) willGas Corrkosion Exploding the other hand under the victims chin and gently tilt the victimsept under control at all times.solvents with flashpoints above 100 F.)require pictograms on labels to alertCylinder Bomb6 After 30 compressions head back (head tilt-chin lift method). Maintaining the open airway,users of the chemical hazards to which Gases Under PressureCor If the load being carried obstructs Explosivesgently pinch the victims nose shut and cover the mouth with yours,forward view, the driver shall be creating an airtight seal, or use a mouth guard as s 9. n. Give th wareEye Damagevictim two full, slow rescue breaths. Each rescue br howBe ethey may be exposed.required to travel with the load trailing.rosive open the airway andeath should Each pictogram consists of a symbol onto Metals and keep a clear view Self-ReactivesThe driver shall be required to look inof RampsSkin Corrosion/BurnsOrganic Peroxidesbe delivered in one second and should cause the chest to rise. the direction of, begin rescue breathing: Make sure you take a regular (not a deep) breath between each.a white background framed within a redof the path of travel.rescue breath. This prevents you from getting dizzy or lightheadeddescending gradesWhen ascending ornd fall after theborder and represents a distinct hazard(s). Watch the victims chest. If it does not clearly rise a in excess of 10 percent, loaded trucks first rescue breath, perform the head tilt-chin lift again before giving upgrade. Flame Over Environment Skull and the second rescue breath. shall be driven with the loadthe label is determinedCircle 6. NeverCrossbonesThe pictogram on (Non-Mandatory)On all grades the load and load8. Avoid by the chemical hazard classi\x1f cation.engaging means shall be tilted back Leave Truck Do not try more than two times to give a rescue breath that makes the chest rise, because it is important to continue chest compr and raised only as far Pedestrians Acute Toxicity if applicable, essions.as necessary to clear the road surface. Trucks shall not be driven up to anyone Oxidizers Unattended (Fatal or Toxic)7. Repairs & Aquatic Toxicity7 After delivery of twoRepeat the combination of 30 chest compressions and two rescue2013 EDI W0720 standing in front of a bench or otherin Maintenance d db a A powered industrial truck is unattendeduu ors.t s. to n n n, i t c to fr ac ntesyocro snecrevrinciens.g T yhoue ri npfoarrtmicautlioarnsiist upartoiovnid aend dw aitnhytshpee cuinfidce qrsuteasntidoinnsgotrh acto anncyer pnesr syoonuomra eyn htiatyv e. fixed object. No person shall be allowedwhen the operator is 25 ft. or more away breaths, remembering to release all pressure between pushes and toto stand or pass under the elevatedThis product is designed to provide accurate and authoritative informatifoonr . aHonyw deavmera, giet si sa rniostin ag s ou fromthe lnaadb viilciteyatnod u dseoe whichremainsinviewbts toitf tthee f u sel eogra i h ins optr pordouvcidt eYloegua alr oe puirngioend so nco a syu lstp aeci fawatch the chest rise and fall during breaths. You should continue thisportion of any truck, whether loaded an itn at any is o timef od powered industrial may not or whenepartie theImvpoolvretIf ncorteea:tTinhgi,s pr adpupcrionvge or ari sutrseibuyt itnhgetphuisrc phrosdeurc otn isly n. Toth liisa bfolermtruck be shared publicly or with third vehicleoperator leaves the verrescue breaths: combination of compressions/breaths until an AED arrives, the victimor empty. Unauthorized personnel shallis found to be in need of repair, defective,vehicle and it is not in his/her view.begins to move or EMS personnel take over CPR. not be permitted to ride on poweredor in any way unsafe, the truck shallindustrial trucks. be taken out of service until it has beenWhen left unattended, load engaging restored to safe operating condition. means shall be fully lowered, controls All repairs shall be made only byshall be neutralized, power shall be shut EMERGENCY INFORMATION: CPR VOLUNTEERS: This product is designed to provide accurate and authoritative information. However, it is not a substiet uintef oformr laetgiaolnisp authorized personnel. off, and brakes set.or medical advice and does not prohvaitd aen lyeg pael rosor nm oerd eicnatli toyp iinnvioonlvse odn i na ncyre saptiencgif,i pc rfaodctusc oinr gs eorrv idciesstr. iTbuhtninsug ltth ainsaptrtoodrnuectyisr novoitd leiadb wlei tfoh rt haen yu dndamerasgtaensd airnisgi ntg out of the use or inability to use this product. You are urged to co ave.911OR Name: _______________________ Phone:________________________________ and/or medical profesional concerning your particular situation and any specifico qcupeisetdio onns loyr w choennc ethrne su ysoeurism laegy ahlilbyit ed.oAmbulance:__________________________________________________ Name: _______________________ Daily Inspection Checklistconmlep sel slepde ctiof idcaol lsyo a. lAlonwye odt hine rt hpeh ointsotcroupcytiionngs o, rC roemprpoldyRucginhgtpini roadnuyc ftosr mma,y w bhee tphheort in whole or in part, is strictly prohULocal Emergency Phone #:______________________________________Phone:________________________________be performed before each shift to ensure safe operation.CPR Kit Location:______________________________________________ Name: _______________________ Phone:________________________________CheckIt is imperati for anvye defects that a safety in thecheckitemsbelow before duty: AcceleratorFuel LevelHydraulic ControlsOil Leaks2015 EDIwww.complyright.com Battery ConnectorE Overhead GuardOil Pres W03 r 2 e 4Onilg Lineevel su For More Information, Please Contact: BRadiator LevelSteeringDaistctehrayr ge IndicatorGauges BrakesParkingHornLiegahdt sandTailU NameH Nnouisseusal BrakesServiceHour MeterLightsWarningTires TelephoneThis product is designed to provide accurate and authoritative info liramblaet ifoonr. a Hony wdeavmera, giet si sa rniosit nag s ouubts toift uthteefuosre l eogra iln aadbviliicteyatnod u dseo eths inso ptr pordouvcitd.e Y loeuga al roep uinrgioedn st oo nc oannsyu lstp aenci afitct ofranctesy o cro snecrevrinciens.g T yhoeu rin pfaorrtmicautiloarnsiist upartoiovind aendd w aitnhytshpee cuinfidce qrsuteasntidoinnsgothr conceiIn mvpoolvretadn itn n corteea: tTinhgi,s p isr oadpupcrionvge do rf odri sutsreib buyt itnhgetphuisrc phraosdeurc ot nisly n. oTthis form may not be shared publicly or with third parties. at any rpnesr syoonuomr aeyn htiatvy e.2016 ComplyRight, Inc. 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