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CALIFORNIA ON-SITE STATION TRAINING FORM - NEI V EMPLOYEE TRAINING VERIFICATION <br /> Site Number 1205 _ Dealer <br /> Street Address I I iq <br /> 9 / <br /> City,zip Code_LaJAa 12q 5 3 36 <br /> Employee Name(Print) JL?�E PN 1 IV E CU MBS' <br /> I acknowledge that I have received and understand environmental compliance training in <br /> the following areas (please initial): <br /> I <br /> �— - r InitI&IT Date <br /> UST Sretem Operations <br /> J. I he types and locations of the tanks at the station <br /> 2. The type and operation of the leak detections stem <br /> 3. For electronic monitors daily monitoring checkC A2 �,2 <br /> log and alarm to <br /> Hazardous Materials Mana ement Hazardous Materials Ma a entent/Business Plan <br /> 1. Which materials at the station are hazardous 10 <br /> 2. Where these materials are stored <br /> 3. How these materials are to be handled stored,and disposed of <br /> 4. What Material Safety pate Sheets MSDSare and where the are k t at the station <br /> 5.Training topics included in the HMMP, including review of MSDSs i nd the emergency <br /> response plan Lrc /p <br /> Waste Management Procedures <br /> t. Procedures in the service ba U , <br /> 2. The correct manaaement for products in the station <br /> 3. Proper labeling of wastesa <br /> 4. The importance of manifesting or having a receipt for all hazardous i iaterials that leave the <br /> site fOf <br /> SpIII and Leak Response(SpW Response Plan) <br /> L. Location of spill response equipment _ C <br /> 2. Location of spill or leak contact list,reporting procedures12C. a <br /> 3, Location of emergency fuel shut-off switch <br /> I <br /> in <br /> Reconctliatfon <br /> I. How to er£orm accurate inventory control <br /> 2. Follow-u of asoline ;nvonto overs a/shorts a variance 14ettc 3. Re ortin and maintainin invento recordsDaily Self inspection* <br /> 1. Type and operation of vapor recovery ui ment at the facilit 2. How to erform dail ins coon of i meat3. Procedures fornon-com liance a ui ment to out of order cum let maintenance to Rec�rd Kee ip ng(Maintenanee, monitor testingwastes Ins ec ions Invento ermlts tra1. location where records are k t C_ 1 <br /> 2 T s of records maintained at the facility/length of time each record should be kept <br /> r - o <br /> / • ! / <br /> Employer Signature Social Sec. Nu er D to <br /> Training verified by q-ue <br /> Dealer/Instructor Date <br /> For facilities within the jurisdiction of the South Coast Air Quality Maxgement District, the training <br /> employees must be certified by the agency. provided to <br /> MAINTAIN THIS FORM THE ENTIRE TIME THE EMPLOYEI WORKS AT THE FACILITY 00957 <br /> 20 ,14 wd sz: ta traz-sz-130 <br />