"Spcc Pre-examination Training Form" - Georgia (United States)

Spcc Pre-examination Training Form is a legal document that was released by the Georgia Department of Agriculture - a government authority operating within Georgia (United States).

Form Details:

  • Released on November 12, 2019;
  • The latest edition currently provided by the Georgia Department of Agriculture;
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  • Fill out the form in our online filing application.

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SPCC PRE-EXAMINATION TRAINING FORM
Company Name: ______________________________________ Company License #: _____________ Date of Hire: ______________
Employee Name: _______________________________________ Date of Birth: ____________
Classroom Training (10 hours required)
Date: Hours:
Trainer:
Cert #:
_____ _____ State and Federal laws and regulations.
____________________
__________
_____ _____ How to read and interpret a pesticide label.
____________________
__________
_____ _____ Handling of emergencies and spills, understanding common types of pesticide poisoning. ____________________
__________
_____ _____ Emergency practical treatment, how to obtain medical care for pesticide exposure.
____________________
__________
_____ _____ Proper methods of storing, mixing, loading and transporting pesticides.
____________________
__________
_____ _____ Proper methods of handling, applying and disposing of pesticides.
____________________
__________
_____ _____ Safety and health issues including proper use of personal protective equipment.
____________________
__________
_____ _____ Hazards posed by toxicity, exposure and routes of entry when handling pesticides.
____________________
__________
_____ _____ Acute and chronic reactions to pesticides.
____________________
__________
_____ _____ Adverse effects to the environment from drift, run off, and groundwater contamination.
____________________
__________
_____ _____ _______________________________________________________________________
____________________
__________
_____ _____ _______________________________________________________________________
____________________
__________
_____ _____ _______________________________________________________________________
____________________
__________
Total: _____
0.00
On the Job Experience Record (70 hours required)
Date:
Hours:
Trainer:
Cert/Reg #
Category:
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
Total:
_______
0.00
If yes, registration number: __________
Is this training to retest for renewal? Yes
No
SPS: 18-01 SPCC PRE-EXAMINATION TRAINING
Is this training to retest after failing the 3
rd
examination? Yes
No
FORM ISSUED: 3-13-18
REVISED: 11-12-19
SPCC PRE-EXAMINATION TRAINING FORM
Company Name: ______________________________________ Company License #: _____________ Date of Hire: ______________
Employee Name: _______________________________________ Date of Birth: ____________
Classroom Training (10 hours required)
Date: Hours:
Trainer:
Cert #:
_____ _____ State and Federal laws and regulations.
____________________
__________
_____ _____ How to read and interpret a pesticide label.
____________________
__________
_____ _____ Handling of emergencies and spills, understanding common types of pesticide poisoning. ____________________
__________
_____ _____ Emergency practical treatment, how to obtain medical care for pesticide exposure.
____________________
__________
_____ _____ Proper methods of storing, mixing, loading and transporting pesticides.
____________________
__________
_____ _____ Proper methods of handling, applying and disposing of pesticides.
____________________
__________
_____ _____ Safety and health issues including proper use of personal protective equipment.
____________________
__________
_____ _____ Hazards posed by toxicity, exposure and routes of entry when handling pesticides.
____________________
__________
_____ _____ Acute and chronic reactions to pesticides.
____________________
__________
_____ _____ Adverse effects to the environment from drift, run off, and groundwater contamination.
____________________
__________
_____ _____ _______________________________________________________________________
____________________
__________
_____ _____ _______________________________________________________________________
____________________
__________
_____ _____ _______________________________________________________________________
____________________
__________
Total: _____
0.00
On the Job Experience Record (70 hours required)
Date:
Hours:
Trainer:
Cert/Reg #
Category:
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
__________
_______
___________________________
_____________
____________________
Total:
_______
0.00
If yes, registration number: __________
Is this training to retest for renewal? Yes
No
SPS: 18-01 SPCC PRE-EXAMINATION TRAINING
Is this training to retest after failing the 3
rd
examination? Yes
No
FORM ISSUED: 3-13-18
REVISED: 11-12-19
SPCC PRE-EXAMINATION TRAINING FORM DEFINITIONS
The Georgia Structural Pest Control Commission (SPCC) PRE-EXAMINATION TRAINING FORM is the record to verify that the training requirements of Rule 620-3-
.02(1)(e) are met for new employees and employees that are required to retest. The record must be maintained by the pest control company for a period of two
years.
Date of Hire – date began employment at company to train for an employee registration.
Date of Training – actual date training was provided including classroom and on the job experience.
Category – the operational category of the subject matter taught (FUM: Fumigation; HPC: Household Pest Control; WDO: Wood-destroying Organisms).
Classroom Training and Hours – employee must complete a total of 10 hours of classroom training. This training must cover each of the required training areas
listed on this form. The training may also include additional topics that are included in the Employee Registration Manual. The training must be provided by a
certified operator or an approved SPCC instructor.
Employee Registration Manual & Training – this manual is published by the SPCC and is intended to prepare technicians for the Employee Registration
Examination. Training on the manual is recommended and some of the other topics in the manual include pest identification, pest biology, IPM and application
techniques. The additional lines on the form are provided to record training topics from the Employee Registration Manual.
Employee Registration Examination – this exam includes 100 questions and is based on the Employee Registration Manual.
On the Job Experience Hours – actual hours of on the job training by the employee. Must be a total of 70 hours in the category(ies) in which registration is
sought. This training must be provided by a certified operator or registered employee.
Trainer & Cert/Reg# - The name of the responsible certified operator, registered employee and/or approved instructor that provided the training and the
certification or registration number of the trainer.
Is the training to retest?
If employee fails the employee registration examination 3 times, the classroom training is required to be repeated before retaking the examination.
If employee registration is not renewed before October 1
st
of odd numbered year, training requirements are required to be repeated before re-
examination.
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