Health & Safety Forum

NOTICE TO ALL PSM TRAINING ORGINIZATIONS

Process Safety Management Certification
Information Transmittal

In order to properly enter PSM training data into our Passport database
the following fields of information are requested:

· Name of Student;

· Social Security Number;

· Date of Certification Training;

· Local Union Affiliation;

· Name of Instructor;

· Type of Training;

(BUILT-RITE, MOST, OSHA 10, Other)

· Means used to verify that the student understood the training;

(Type of test given, 85% Passing grade required)

Send Confidential By Mail or Fax to:
Gert Anthony
215-732-7479
April 2002