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UNDERGROUND STORAGE TANK SYSTEM DESIGNATED OPERATOR FACILITN' EMPLOYEE TRAININ(, RECORD For use hy Unicloc•s Member . I: c nwc Co- It -here upplloved h ' v vour LOLVI ,hu-IS(IIC-1 I:` r Al rority Cite-cl: Title _'3. Un•. 3, Ch. 16 Calijoruiu C'otk' u! Regulations (CY-10 Facility Name: (� _—. .. --- - - -- --- -- ----- Facility Site Address: �, � Cit} : Section 2715 of Title 23, California Code of Regulations. requires that Designated Underground Storage -Dank Operators provide training to facility employees who have responsibilities associated with the operation and:'or maintenance of underground storage tank (UST) systems. This training must be provided by July 1. 2005; and every 12 months thereafter. For faciIity employees hired after July 1, 2005, the initial training must be provided within 30 days of the date of hire. At least one of the facility employees present during operating hours must have current training. This training must include, but is not limite o, the following items as specified in 23 CCR Sections 2715(t)( i ) and (2): Operation of the UST system in a manner consistent with the facility's Best Management Practices; The employee's role with regard to UST monitoring equipment as specified in the written USS- Monitoring Plan: The employee's role with regard to spills and overfills as specified in the written UST Response Plan: Name(s) of contact person(s) for emergencies and monitoring equipment alarms; ❑ For facilities that are not routinely staffed, facility employee responsibilities as specified in the training program approved by the local UST regulatory agency. 23 CCR y 2715(f)(3) requires that a list of employees who have been trained by the Designated UndergrOUnd Storage "Dank Operator(s) be maintained on-site, or off-site at a readily -available location if approved by the local agency, and provided to the local agency upon request. Completion of this form v ill satisfy UST training record keeping requirements. The folloxving emplo\ ees have been trained as required by 23 CCR Sections 2715(t)( I ) and (2): Facility�Employee Name Training Date Hire Date Tr finer Name' — G,SICL�L�a�� -- VI -7 - jf 0 A�Na (Continued on reverse) if hired after July 1, 2005. Trainer must be a current Designated UST Operator for the facility at the time of training. UN -061 - 1/2 www.unidoes.org 07/13/0,5