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i Certificate of Designated Employee / Class 'C' � r{ J Operator Training Su IV„�E§ � (CA only) Section 2715 of Title 23, California Code of Regulations, Minutes that Designated Underground Storage Tank Operators provide training nsibilities associated with the operation and/or maintenance of underground storage cant (UST) to facility cent°Yves who have respo systems. This training most be provided by Judy I, 2005, and every 12 momhs one often. For facility employees hired curing OperatngOhum initial training most be provided within 30 days of the date of hire. At lean area of the facilitymemployees Pte° most have Lmrel training. This training must include, but is not limited to, the tollowmg items specified m 23 CCR Safiort¢ 271 t(M I) and(2): ,j Operation of the UST system in a manner consistent with the facility's Best Management Pm UM,, ❑ The employse's role with regard to UST monitoring equipment as specified in the written UST Monitoring Ptan; ❑ The employce's role with regard to spills and overfills as specified in the written UST Response Man; ❑ Name(s)of contact persoms)for emergencies and monitoring equipment ularrtts; ❑ For facilities that aro not routinely staffed,facility employee responsibilities as specified in the training program approved by the local UST regulatory agkmcy. 23 CCR§2715(f)(3)requoes then a list of employees who have been mined by the Designated Underground Storage Tank Operatorts)be maintained on-ti e,or off-site at e laddy- aidable location if approved by the local agency,and provided to the local agency upon request Completion of this form will satisfy UST training record keeping requiremets By signing below,the Designated Facility Employee/Class"C”Operator agrees that helshe has received training in accordance with the regulations stated above,and received training in the following site-specific information Location of MSDs Location of Fire Extinguishers 1 Location of Emergency Mecting Arras ❑ UST Diagram Showing sensor locations,sumps.UDCs,LLDa,piping and annular spuces ❑ Instruction on who to contact far alarms indicating a potential relearn ❑ Alarm location ❑ Alarm log location l7 Emergency shut off switches(where applicable) J Location of spill reaponce materials Facift 1. Code Cit' or Rebroace ID Facility Naos Facility Addreax MpNTCp Manteca CA FO REGEN 2551 E.Louise Ave. Lathrop KINGCA Mid City Ca fievncs Road foci Ca PO Rcge Turlock TURUCA Turlock Ca FO Regen 1190 Piedras,Road RE( E F13 0 7 2018 ENVIRONMENTAL HEALTH DEPARTMENT Training Date:September 27 2017 Training Expires: 111910tber 27.2018 Trainer Name: lienµ'ilbee ICC a: �Z�7 Z6� l l(c Expiration: !'Z t-2!09 Authonred Signature: QA/QC APPROVED 10/12/201710:31 AMBrandon B