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SUN-9-2006 12:37 FROM:CIRCLE K <br /> 8584116 T0: 19512705121 P.9�11 <br /> CAL—JRNIA ON-SITE STATION TRAINING-FORM <br /> SiteNumber Z/� S Manager Name MRrY <br /> Street Address (��f 7 D Ca w to r i ceq Dy ' <br /> City,Zip Code <br /> _L q0 <br /> Employee Name(Print) Sia n ' nt^hP <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 Z <br /> 2. For electronic monitors, daily monitoring check log and alarm to g <br /> 3. For electronic monitors, who to call in the event of an alarm <br /> Hazardous Materials Mana ement Hazardous Materials Mana ement/Business Plan <br /> 1. Which materials at the station are hazardous G <br /> 2. Where these materials are stored <br /> 3. How these materials are to be handled, stored, and disposed of 6 <br /> 4. What Material Safe Data Sheets -SDS)are and where they are kept at the station Z <br /> 5. Training topics included in the HMMP, including review of MSDSs and the emergency <br /> res onse Ian z� <br /> Waste Mana ement Procedures <br /> 1. The correct management for products in the station g <br /> 2. Proper labeling of wastes g <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 Z <br /> Spill and Leak Response (Spill Response Plan <br /> 1. Location of s ill response a ui ment <br /> 2. Location of spill or leak contact list,reporting rocedures 2 <br /> 3. Location of emergencX fuel shut-off switch <br /> Inventory Reconciliation <br /> 1. How to perform accurate fuel inventory control <br /> 2. rollow-up of Rasoh a inventoEy overage/shortage variance <br /> 3. Reporting and maintaining inventory records and fuel delivery receipts <br /> Daily Self Inspection* <br /> 1. Type and operation of vapor recovery equipment at the facility <br /> 2. How to perform daily inspection of equipment 2$ <br /> 3. Procedures for non-compliance equipment to out of Order), complete maintenance log 6 2g <br /> Record Kee in aintenance monitor, testing, wastes inspections, inventory, permits, trainin , etc. <br /> 1. Location where records are ke t 2� <br /> 2. Types of records maintained at the facility/length of time each record should <br /> ZZ4�4 C, agn xey G z <br /> Employee Signature c. Stc. # Emp. ID# Date <br /> Training Performed By_`e�\,Ags- 1 M.,_ , <-I" —L-42j(� <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 />