Document dnqRBo4vKQ7QYD4Lg7gGmJ26q
EMPLOYE JOB & STATUS CHANGE NOTICE
TO: f?, fy)/)C-L//J
NAME Leotj
DEPT.
7 T-C-# /,< /_______
DATE
1.
TRANSFER (REG.)
I TAward Notice Only
Bid Job
Bumped
l I Assigned
I I Returning
1--L Relief Work
TRANSFER (UT
E>g Regular
5 -Year Seelecjtflon
3.
EMPLOYMENT
1 "i New Employe
1 I Ret. from Lay Off
r~j Ret. from L. 0. A.
1__ | Ret. from Absence
Remarks:__________________________
K
~
...
Require Explanation__________
FROM TO t'lLC.
DEPT
Replacing
___*-rrr>______________ -------______
JSen
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--Address /^/r (l/Jz /fl
4. SEPARATION
TEMPORARY
IZU Lay Off |----- 1 Off W/0 Pay T~~l Military Service I I Leave of Absence
r~ I Other (Specify)
Ua^rA^ifL /Phone
PERMANENT
t--J Retire^
HD Resign* EH T. Sc P. D. 1 1 Dropped* 1 I Discharged*
PCB-ARCH-EXT0375528
WG K !lf9
,:rev. e/eo
W. G. KRUMMRICH PLANT
,
;
EMPLOYE INDOCTRINATION CHECK LIST
DEPARTMENTAL
GENERAL
| | STARTING TIME.
| | LUNCH PERIOD .
| I QUITTING TIME,,
| | SHIFT ROTATION.
| | DAYS OFF-------------
| | RATE OF PAY $.
PER HOUR
| | SMOKING RESTRICTIONS WHEN__________________ WHERE.
| I PERSONAL TELEPHONE CALLS - Emergency Only.
| | SAFETY EQUIPMENT ISSUED - USE AND REPLACEMENT
| | FIRE ALARMS
TELEPHONE - Dial 200 ZONE ___________ i-------------- ------
DEPT..
MANUAL - Location of Alarm Box
. *
| | EMERGENCY MEDICAL AID OR AMBULANCE - Dial 400
| I LOCATION OF EMERGENCY SHOWERS
.
| I PAGEMASTER - DAYS - Dial 434 for Maint. Pers.
.
"operator" for others
300 for night & wk. ends.
\ I ABSENCES - Call In and Log No. Procedure .
.
| | LOCATION OF WASHROOM & TOILET
.
| | LOCATION OF BULLETIN & OVERTIME BOARDS
INSTRUCTIONS TO SUPERVISOR: Fill out in duplicate if this is a
new employe. Forward tear-off portion of original to Employment
Department. Give remainder of original to employe. File carbon for
duration of employe's stay in department.
,
T/C NO.
TRAINING
| |. DEPARTMENTAL SAFETY PRACTICES
| | TIME & PLACE OF RELIEVING
| | OPERATING INSTRUCTIONS - Location & Importance
| | RELATIONSHIP OF JOB TO OTHERS IN DEPT.
| | SCOPE OF JOB & RESPONSIBILITIES
| | HOUSEKEEPING AREA ASSIGNED______________________
| | SAMPLING - Location of Laboratory
1 | RECORDS - Use of forms
.
| | METHOD OF TRAINING - With Whom. For How Long, Method of
Determining Qualification On Job.
'
.
| | DEPARTMENT LOCKER NO. __________ '
ASSIGNED
[^] TOUR OF DEPARTMENT - Introduction to Supervision and Fellow Employes.
JOB ASSIGNED
TO: EMPLOYMENT DEPARTMENT
DATE
INDOCTRINATED B Y
NEW I | EMPLOYE
TRANSFERRED
-
EMPLOYE
PCB-ARCH-EXT0375529