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VL IV V l 1"i,71 Vr"Vn J,^1,4 1V J still ZLY1 <br />DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br />For use by Un/dOcs Member Agencies or where approved by your Local Jurisdictian <br />Authority Cited.- Title 13, Div, 3. Ch. 16 California Code ojRegulatiow (CCR) <br />Facility Name: /' ,„ t--., - •-, _ I _ <br />Facility Site Address: <br />city:— <br />Section 2715 of Title 23, California Code of Regulations, requires that Designated Underground Stopr --- <br />Provide training to facility employees who have responsibilities associated with the Operation <br />rad/oge Tank O <br />aths ancetors <br />underground storage tank (UST) systems. This training must be provided <br />by July <br />i 1. 2005. and every every nonthereaB.erf <br />For facility employees hired after July I, 2005, the initial training must be provided within 30 days of the date of hire. At <br />least one of the facility owing s present during <br />bw <br />is not limited to, the following operating hours must have current training. This training most include, but <br />items as specified in 23 CCR Sections 2715(f)(1) and (2): <br />R1 Operation of the UST system in a manner consistent with the facility's Best Management practices; <br />0 Tho employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring plan; <br />0 The employee's role with regard to spills and overfills as specified in the written UST Response plan; <br />P� Name(s) of contact Person(s) for emergencies and monitoring equipment alarms; <br />❑ For facilities that are not routinely staffed, facility employee responsibilities as specified in the training p <br />approved by the local UST regulatory agency. rogram <br />23 CCR § 2715(f)(3) requires that a list of employees who have been trained by the Designated Underground Storage Tank' <br />Operator(s) be maintained on-site, or off-site at a readily -available location ifNrproved by_* 1_oWAgenc�,, and provided tc <br />the local agency upon request. Completion of this form will satisfy UST training record keeping requirements. a. The following <br />employees have been trained as required by 23 CCR Sections tisfyx 1) and (2): <br />rartu am to ee Name _ <br />Trill Date <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />If hired atter My 1, 2005. <br />' Tniaer must be a cuaent Deaignaud UST Opentnr for dx facility Al the ame of training. <br />UN -061 - l/1 <br />www.uaidon.erl <br />07/1315 <br />