| City of St. Louis Department of Personnel Safety and Health Regulations Manual |
The City of St. Louis Safety and Health Regulations Manual have been converted to electronic format by the staff of the St. Louis Public Library. This electronic version has been done for the interest and convenience of the user. These are unofficial versions and should be used as unofficial copies.
Official printed copies of the City of St. Louis Safety and Health Regulations Manual may be obtained from the Personnel Officeat 1114 Market Street, Room 703, St. Louis, Missouri 63101.
Forms
EMPLOYEE:
I have read and understand the City Safety Manual and will follow the rules and guidelines
it contains.
Department Number______________________ Department
Name_________________________
Division Number_________________________ Division Name___________________________
Employee name______________________________________(print)
Social Security Number_____________________________
Employee signature__________________________________Date______________
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I have instructed the above employee in the safe working practices for
______________________________________________________________________
(describe job, operation, activity)
Supervisor's name______________________________________(print)
Supervisor's signature______________________________Date______________
When completed, this form should be removed from the Safety Manual and sent to your
Department's Safety Coordinator.
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