Sign-Off Form - Walinga Ultra-Vac 6614D Operator's Manual

2.10 SIGN-OFF FORM

Walinga Inc. follows the general Safety Standards specified by the American Society of Agricultural
Engineers (ASAE) and the Occupational Safety and Health Administration (OSHA). Anyone who will be
operating and/or maintaining the Ultra-Vac® must read and clearly understand ALL Safety, Operating and
Maintenance information presented in this manual.
Do not operate or allow anyone else to operate this equipment until such information has been
reviewed. Annually review this information with personnel.
Make these periodic reviews of SAFETY and OPERATION a standard practice for all of your equipment. We
feel that an untrained operator is unqualified to operate this machine.
A sign-off sheet is provided for your record keeping to show that all personnel who will be working with the
equipment have read and understand the information in the Operator's Manual and have been instructed
in the operation of the equipment.
SIGN-OFF FORM
DATE EMPLOYEE'S SIGNATURE EMPLOYER'S SIGNATURE
15