W2operator Training Group, LLC

W2Operator Training Group, LLC.

131 Port Watson Street, Cortland, NY 13045

Phone: 607-753-1477 Cell: 607-345-0016 Fax: 607-753-1479

E-mail:

Confined Space & Competent Person Training

Date: ________________, 20____

6 Contact Hours DOH (all day attendees only) 6 Contact Hours DEC (all day attendees only)

7:00 – 8:00 AM Registration for Confined Space, Coffee and Donuts

8:00 – 9:30 AM Power Point Slides on Confined Space (3.0 Hrs)

Attendant

Entrant

Case Studies

Break For Supervisors

9:45 – 11:15 AM Hands-on Demonstration

Permit Required Entry Form

Air Quality Testing, Ventilation and Recording Information

Tripod, Harness, and Retrieval

Entry Form Closeout

11:15 AM – 12:15 PM Lunch and Registration for Competent Person

12:15 – 1:15 PM Power Point Slides on Trenching, Competent Person (3.0 Hrs)

Case Studies

Soil Demonstration

Break Discussion

1:30 – 3:30 PM Hands-on Demonstrations

Excavation Techniques

Shoring Boxes

Ladders and Placement

Work Zone Protection

Worker and Pedestrian Safety

Please email or fax this form to W2O in order to reserve your seat.

REGISTRATION

Name: NYSDOH#

Organization:

Address:

E-mail: Phone:

Fax: Cell Phone:

Visa/Master Card#

Expiration Date: 3-Digit Code (from back)

CC Billing Address Billing Zip Code

Payment: AM Session & PM Session are $50 EACH = $100 Total [ ] Check [ ] Credit Card [ ] Voucher

Member of New York Section American Water Works Association