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ON-SITE STATION TRAINING FORM <br /> ANNUAL REFRESHER TRAINING VERIFICATION <br /> FOR FACILITIES LOCATED OUTSIDE OF CALIFORNIA <br /> Site Number i;o r Dealer <br /> Street Address j �0!{'JO ( w- iv la je <br /> City,Zip Code_ 16.a 4�%Y'� r A <br /> Employee Name (Print) M 131 <br /> 1 acknowledge that I have received and understand environmental compliance training in <br /> the following areas (please initial): <br /> Iultial Date <br /> Hazardous Materials Management <br /> I. Which materials at the station are hazardous V10 -69 Where these materials arc stored q-Lo-(XZ <br /> 3. How these materials are to be handled stored and disposed of 0 <br /> 4. What Material Safety Data Sheets SDS are and where they are kept at the station -7-to -o <br /> 5. Emergency response procedures -h-° <br /> Waste Management Procedures <br /> 1. The correct management for products in the station �liD4tr <br /> 2, Proper labeling of wastes -lu- <br /> 3. The importance of manifesting or having a receipt for all hazardous materials that leave the <br /> site (employees are not to sign hazardous waste manifests <br /> Spill and Leak Response <br /> 1. Location of spill response a ui ment -� <br /> 2- Location of spill or leak contact list reporting procedures '1O-*$ <br /> 3. Location of emergency fuel shut-off switch <br /> (O14 PW 9 <br /> - <br /> mployoe ature ec.oc. S #or Emp. ID # are <br /> Training verified by �� & <br /> Dealer/Instructor D& <br /> MAINTAIN THIS FORM THE ENTIRE TIME THE EMPLOYEE WORKS AT THE FACILITY 11I1I161 <br /> Rev. 10/2004 <br /> br 'd we b�:: ze eeez-rr-Nnr <br />