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Environmental Health & Safety
EH&S
TEL NO: (818) 677-2401
FAX NO: (818) 677-5853
MAIL DROP: 8284
Hazard Communication Quiz/
Employee Acknowledgement Form
LINE

Hazard Communication Quiz
1.
Hazardous substance containers must have proper labeling.
T
F
2.
A Material Safety Data Sheet is required for all hazardous substances in the workplace.
T
F
3.
If I am required to work with a hazardous material, the MSDS should be available (via department or web) for me to review.
T
F
4.
My Manager/Supervisor is responsible for instructing me in Hazard Communication prior to my starting my work assignments.
T
F
5.
A list of all known hazardous substances at CSUN is available for review in the EH&S office.
T
F
6.
A typical MSDS will contain health hazard data.
T
F
7.
In case of a chemical spill, immediately call Public Safety at 911 or EH&S at extension 2401.
T
F
Answers: 1-T; 2-T; 3-T; 4-T; 5-T; 6-T; 7-T.

Employee Acknowledgement Form

Hazard Communication Program - Your "Right-To-Know" Guide
I have read the "The Hazard Communication Program - Your Right to Know Guide", completed the quiz and reviewed the answers.

I AM FAMILIAR WITH:
1.
the chemicals I work with,
2.
the hazards associated with these chemicals, and
3.
the proper personal equipment to use to protect myself when using these chemicals

Employee Name:
_____________________________________________
Title: _____________________________________________
Employee ID/Peoplesoft #: _____________________________________________
Department: _____________________________________________
Extension: _____________________________________________
Signature: _____________________________________________
Keep the Original Employee Acknowledgement in Your Departmental Personnel Files
Send a Copy to EH & S at Mail Drop 8284
Created: April 2001