Wood Group Power Plant Services, Inc.

HSE Training Certification

To be completed by the person performing the training event. Scan and retain on
iShare or other network drive. DO NOT RETAIN RECORD OF TRAINING
CERTIFICATION ON LOCAL HARD DRIVE.

This Certification confirms that _____________________________ (employee name),

________________________ (job title) successfully completed HSE training for:

Control of Hazardous Energy Lockout/Tagout

Specifically, the employee was trained and understands the following: (1) Overview of the HS06
Procedure, (2) step by step review of WGPPS LOTO process, (3) key control and accountability, (4)
contractor requirements under HS06, (5) WGPPS LOTO forms and documents, (6) use of computer-
based LOTO administration tools, (7) program review and audit requirements, and (8) 29 CFR
1910.147.

On (mm/dd/yyy): _____/_____/_________

Method for determining competency: Test Hands-on Demonstration

Other: __________________________
 Wood Group Power Plant Services, Inc.

HSE Training Certification

Employee signature: __________________

Name of Trainer: ______________________ Signature of Trainer: ____________________

Refresher training due (mm/dd/yyyy): _____/_____/_________ (note, must be one (1) year
from the date of this training event)

Level of Training: Affected Employee

Authorized Employee

Attachments (check all that apply) Test Vendor certificate

Other: __________________________