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Atachment D <br />RESPONSIBLE MANAGER/SERViER TRAINING CERTIFICATION <br />Establishment & Addr,essil <br />IF <br />r <br />................... <br />Signature <br />Printed name <br />a xl4-ilvV4gM&l 11,11, 1 1 <br />Manager's Printed Name <br />Dait'le <br />Date of Hire <br />III <br />Dat�e'll of Triain'i'ng <br />