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JOHN DOE
Job Title:
Foreman
STAC #:
J2B3C26
Company Name:
YOUR Company
Labor Provider Info: (If Applicable):
Emergency Medical Information
Contact Jane @ 555-555-5555
Current Project
Project Name
Address
City
New Start
1234 Street Name
Cincinnati
Special Project
123 Street
Cincinnati
Licenses
Name
Completed
Expiration
Lic. #
Doc
Related
Driver License
1/2/2017
1/2/2021
Safety Program
Name
Completed
Expiration
Lic. #
Doc
Related
ACI Program
3/1/2017
3/1/2020
Company Specific
3/14/2016
Toolbox Talk / Safety Meeting
Name
Completed
Expiration
Lic. #
Doc
Related
Employee ID Card Clock In
8/8/2018
Example Toolbox Talk
8/15/2018
First Aid Awareness
6/1/2018
Training
Name
Completed
Expiration
Lic. #
Doc
Related
40-Hour HAZWOPER
8/11/2016
1
8-Hour HAZWOPER Refresher
10/2/2017
10/2/2018
First Aid CPR AED
8/12/2017
8/12/2019
Industrial Forklift
12/15/2015
12/15/2018
OSHA 30-Hour Construction
2/12/2016
2/12/2020
Steel Erection Training
6/13/2003
Background Check
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Drug Test
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Medical
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