Sign-Off Form - Walinga AGRI-VAC 5614 Operator's Manual And Parts Book

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 Agri-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 NAME EMPLOYER'S SIGNATURE
Agri-Vac Operator's Manual 34-18148-6 18