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UNDERGROUND STORAGE TANK OSTEM <br /> DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br /> Far use by Undoes Member Agencies or where approved by your Local Jurfsdictrm <br /> Authority Cited.- Tide 23,Div.3,Ch. 16 Califonda Code ofRegulatimis(CCR) <br /> Facility Name: B711 4o I I <br /> Facility Site Address: NE _(Rl7 City: Sk ,rbti Cg=j <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 /> oudergr0lmd storage lank(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(1x1)and(2): <br /> ❑ Operation of the UST system in a manner consistent with the facility's Best Management Practices; <br /> ❑ The employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring Plan; <br /> ❑ The employee's role with regard to spills and overfills as specified in the written UST Response plan; <br /> ❑ 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 program <br /> approved by the local UST regulatory agency. <br /> 23 CCR§2715(fx3)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 if almroved 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 2715(t)(1)and(2): <br /> Facility Employee Name Training Date Hire Date Trainer Nam <br /> berms PL., g-1 S 06 %n <br /> vC J-119101 <br /> le-o L�Cl a6 <br /> (Continued on r erre) <br /> 'If hired after July 1,2005. <br /> 'Trainer must be a c t Designated UST Operator for the facility at the time of training. <br /> UN-061-12 www.unidoa.org 07/13/05 <br />