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ti <br />TRAINING RECORD <br />Quik Stop Market Number: I 7 <br />Employee Name (Print): A,� i F- t `1 Q-h-r6k o p k <br />Purpose of Training:---`�New Employeelltvtial Training <br />New Assignments or Changes in Operating Equipment or Routine <br />Annual Refresher Training <br />Topics Covered; <br />Hazardous Matenals Management <br />I,- Hazardous Materials Inventory/Location (Part I, HMMP, aka, Business Plan) <br />Ll Workplace Health Hazards and Physical Hazards <br />f-- Location and Use of Material Safety Data Sheets (MSDS) <br />Methods for Safe Handling of Hazardous Materials <br />_LG Emergency Response Procedures and Regulatory Requirements (outlined below) <br />Emergency Response <br />_I�- Emergency Response Plan/Cous hdated Contingency Plan (Part Il, HMMP) <br />t✓ Procedures for Coordination with Local Emcrgency Response Organizations <br />L,- Use of Emergency Response Equipment and Supplies <br />_L--'_ Communication and Alan Systems <br />t.' Response to a Release or Threatened Release of Hazardous Materials <br />i / Response to Fires, Explosions, or Earthquake Related Ground Motion <br />Hazardous Waste Management <br />t/ Hazardous Waste Determination, Accumulation Time & Quantity Limits <br />_1,,' Release Contingency Plan (Integrated with Consolidated Contingency Plan, above) <br />' Storage Area and Container Management <br />_j,% Containers Properly Labeled, including EPA ID Number <br />_j;/ Conducting & Recording Weekly Inspections <br />_,_ Manifest Requirements for Off -Site Transport & Disposal <br />Underground Storage Tank Operation (Conducted by the Designated UST Operator) <br />✓' Operation of the UST System Consistent with "Best Management Practices" <br />�r Facility Employee's Role with Regard to the Leak Detection Equipment <br />_V Facility Employee's Role with Regard to Spills and Overfills <br />Whom to Contact for Emergencies and Leak Detection Alarms <br />Certification: <br />I acknowledge that I have received and completed training in the subjects above, so indicated by my initials <br />on the lines provided. <br />23-1� <br />Trainee Signature Date <br />L • <br />Training verified by C��its y 3 <br />r - <br />Date <br />Z•d 136E:60L6 Zl. unf <br />