Laserfiche WebLink
• ��"-"-' lce, u rKUM:CIRCLE K 8584116 <br /> T0:19512705121 P.B'11 <br /> CAL, JRNIA ON-SITE STATION T,AtR,AINIA _, ORM <br /> ] �� <br /> 1K <br /> Site Number Manager Name C) <br /> Street Address <br /> City, Zip Code�(���� � <br /> Employee Name(Print) El <br /> I acknowledge that I have received and understand environmental compliance training in <br /> the following areas lease initial): <br /> UST S stem O erations Initial Date <br /> 1. The es and locations of the tanks at the station <br /> 2. For electronic monitorq. dail --it-rinly check log and alarm to <br /> 3. For electronic monitors who to call in the event of an alarmo <br /> Hazardous Materials Mana ementLD <br /> azardous Materials Management/Business Plan <br /> 1. Which materials at the station are hazardous <br /> 2. Where these materials are stored S <br /> 3. How these materials are to be handled, stored, and disposed of a <br /> 4. What Material Safe Data Sheets SDS are and where the are ke t at the station g G <br /> 5. Training topics included in the HMMP, including review of MSDSs and the emergency <br /> res once ]an a, �S <br /> Waste Maria ement Procedures <br /> 1. The correct management for products in the station <br /> 2. Proper labeling of wastes <br /> 3. The importance of manifesting or having a receipt for all hazardous materials that leave the <br /> site(store personnel are not to sign hazardous waste manifests) <br /> Spill and Leak Response (Spill Response Plan <br /> 1. Location of spill response equipment <br /> S <br /> 2. Location of s ill or leak contact list, reporting rocedures a <br /> 3. Location of emergency fuel shut-off switch <br /> Inventory Reconciliation <br /> 1. How to perform accurate fuel inventory control <br /> 2. Follow-up of gasoline inventory overs a/shorts a variance <br /> 3. Reporting and maintaining inventory records and fuel delivery receipts 4/ <br /> Daily Self Inspection* <br /> 1. Type and operation of vapor recovery equipment at the facili <br /> L12. How to erform dail ins ection of a ui meat Ka 14Procedures for non-co Hance a uier , com tete maintenance tocord Kee in aintenance monitortestis wastLocation where records are ke tT es of records maintained at the facili /len of time each record should be ke t <br /> Employee Signature Soc. Sec. #or Emp. ID# Date <br /> Training Performed By 'A <br /> Designated Operator Name Certificate# D ate <br /> ' For facilities within the jurisdiction of the South Coast Air Quality Management District, the training provided to <br /> employees must be certified by the agency. <br /> MAINTAIN THIS FORM THE ENTIRE TIME THE EMPLOYEE WORKS AT THE FACILITY 00982 2/05 <br />