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DOE-HDBK-1078-94
Requester:
Tracking No.:
Date Issued:
1.
Task(s) requiring improvement:
2.
Frequency of the performed task(s):
3.
Consequences of improperly performed task(s):
4.
Reason(s) task(s) require improvement:
5.
Training recommendation(s):
6.
Training action plan if applicable (identify individual/department responsible for delivery of
training):
(Training Analyst)
(Date)
Reviewed By:
(Training Manager)
(Date)
(Requester)
(Date)
(Supervisor)
(Date)
Approve Recommendation
Reject Recommendation
If recommendation is rejected, identify an alternative solution:
(Please return completed form to originator and training analyst.)
67


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