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CALIFORNIA ON-SITE STATION TRAINING FORM C NE EMPLOYEE TRAINING VERIFICATION <br /> Site Number I Z/ 1 Dealer C!/ <br /> Street Address r <br /> City, Zip Code f h d C <br /> Employee Name(Print) - ___ <br /> I acknowledge that I have received and understand el ivironmental compliance training In <br /> the followin areae lease initial): <br /> Initial Date <br /> UST System Operations <br /> 1. The types and locations of the tanks at the station <br /> 2. The tM and operation of the leak detection system <br /> 3. For electronic monitors,daily monitoring check to and star!!! a <br /> Hazardous Materials Management Hazardous Materials Mar MemnttBusluess Plan <br /> 1. Which materials at the station are hazardous -11 <br /> 2. Where these materials are stored <br /> 3. Now these materials are to be handled, stored,and dis osed of -� <br /> 4. What Material Safety Data Sheets(MSDS)are and where they are ke t at the station <br /> 5.Training topics included in the HMMP, including review of MSDSa t nd the emergency <br /> res nse plan <br /> Waste Manage nent Procedures <br /> 1. Procedures in the service bay <br /> 2. The correct management for roducts in the station <br /> 3. Proper labeling of wastes <br /> 4. The importance of manifesting or having a receipt for all hazardous r katcrials that leave thel 6 -A q- Y I <br /> site <br /> Spill and Leak Response(Spill Response Plan <br /> 1. Location of spill response equipment <br /> 2. Location of spill or leak contact list reporting rocedures <br /> 3. Location of emergency fuel shut-off switch v <br /> Inventory Reconciliation <br /> 1. How to perform accurate inventory control - <br /> 2. Follow-up of gasoline inventory overs a/shorts a variance _ <br /> 3. Reporting and maintaining inventory records R 4 - _ <br /> Daily Self Inspection' <br /> LjXpe and operation of vapor recovery equipment at the facility - 1 14-t <br /> 2. How to perform daily inspection of equipment - <br /> 3. Procedures for non-compliance equipment to out of order com le_ maintenance to -11 <br /> Record Keeping Maintenance monitortesting, wastes Inspec 'one Inventory, srmits training,etc. <br /> I. Location where records are kept - i - <br /> 2. Types of records maintained at the facility/length of time each recorc should be kept C11 <br /> Employee Signature Social Sec. Nun ber Date <br /> Training verified by ti SJY$7KCcl- U <br /> Dealer/instructor Date <br /> • For facilities within the jurisdiction of the South Coast Air Quality Mm agement District,the training provided to <br /> employees must be certified by the agency. <br /> i0 " <br /> tilt. A <br /> d Wtl VZ: 10 rtOZ-SZ-1�0 <br />