Jay-Lor A50 - 8 A50;A100 Safety Sign-Off Form

AAA-055-00138 Rev. 1/14/15
Jaylor Owner Manual - 12 - Mini Mixer Models
8.0 A50/A100 SAFETY SIGN-OFF FORM
Anyone who will be operating and/or maintaining the machine must first read and clearly
understand ALL safety, operating, and maintenance information presented in this manual.
Annually review this information with personnel.
An untrained operator is unqualified to operate this machine.
A sign-off sheet is provided for your record keeping to show that all personnel who will be working
with the equipment have read and understand the information in this manual and have been
instructed in the operation of the equipment.
SIGN-OFF FORM
DATE EMPLOYEE’S SIGNATURE EMPLOYER’S SIGNATURE