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UNDERGROUND STORAGE TANK SYSTEM <br /> DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br /> For use by Unidocs Member Agencies or where approved by your Local Jurisdiction <br /> Authority Cited: Title 23, Div. 3, Ch. 16 California Code of Regulations(CCR) <br /> Facility Name: k W 1 k 5C—AJ <br /> Facility Site Address: G , V®�a , ,. ,}yle City: 1v1 a,>)r ccs <br /> Section 2715 of Title 23, California Code of Regulations, requires that Designated Underground Storage Tank Operators <br /> provide training to facility employees who have responsibilities associated with the operation and/or maintenance of <br /> underground storage tank (UST) systems. This training must be provided by July 1, 2005, and every 12 months thereafter. <br /> For facility employees hired after July 1, 2005, the initial training must be provided within 30 days of the date of hire. At <br /> least one of the facility employees present during operating hours must have current training. This training must include,but <br /> is not limited to,the following items as specified in 23 CCR Sections 2715(f)(1)and(2): <br /> PJ Operation of the UST system in a manner consistent with the facility's Best Management Practices; <br /> Z The employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring Plan; <br /> Q The employee's role with regard to spills and overfills as specified in the written UST Response Plan; <br /> b Name(s)of contact person(s)for emergencies and monitoring equipment alarms; <br /> 23 CCR§27150(3)requires that a list of employees who have been trained by the Designated Underground Storage Tank <br /> Operators)be maintained on-site,or off-site at a readily-available location if approved by the local Agency and provided to <br /> the local agency upon request Completion of this form will satisfy UST training record keeping requirements.The following <br /> employees have been trained as required by 23 CCR Sections 27150(1)and(2): <br /> Facility Em o ee Name I Training Date Hire Date Trainer Name <br /> i i. <br /> '^ A 7 3 <br /> iAL k have zt <br /> _- <br /> ru <br /> r <br /> (Continued on reverse) <br /> 'if hired after July 1,2005. <br /> 'Tramer must be a current Designated UST Operator for the facility at the time of training. <br />