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�ury 7 ebbb 12:44 FROM:CIRCLE K 8584116 <br /> 717: 19512705121 P.5,7 <br /> CALJ.—JRNIA ON-SITE STATION TRAININtr,40RM <br /> Site Number Manager Name <br /> Street Address /4;Z ;L <br /> City, zip Code -,Z,47 <br /> Employee Name(Print)_�o e, <br /> I acknowledge that I have received and understand environmental compliance training in <br /> the following areas lease initial): <br /> UST System Operations Initial Date <br /> 1. The es and locations of the tanks at the station ZY o <br /> 2. For electronic monitors, daily monitorin check log and alarm to <br /> 3. For electronic monitors, who tocall in the event of an alarm Ifs 2 06- <br /> Hazardous Materials Mana ementazardaus Materials Management/Business Plan e <br /> 1. Which materials at the station are hazardous _ <br /> 2. Where these materials are stored 6k <br /> 3. How these materials are to be handled stored, and dis used of , & a <br /> 4. What Material Sarety Data Sheets SDS are and where the are ke tat the station 0- <br /> 5. Training topics included in the HMMP, including review of MSDSs and the emergency r� Zt ,J <br /> response Ian <br /> Waste Management Procedures <br /> I. The correct mans ement far roducts in the station <br /> 2. Proper labeling of wastes07 <br /> 3. The importance of manifesting or having a receipt for all hazardous materials that leave the <br /> _site(store personre]are not to sign.hazardous waste manifests) t`^ <br /> Spill andLeak Response(Spill Response Plan <br /> 1. Location of s ill response equipment YL- z of <br /> 2. Location of spill or leak contact list,reporting rocedures <br /> r v <br /> 3. Location of emeLgency emergencyfuel shut-off switch <br /> Inventory Reconciliation <br /> 1. How to perform accurate fuel inventory control <br /> 2. Follow-up ofgasoline inventory overage/shortage variance <br /> 3. Reporting and maintaining inventoa records and fuel delivery recei is <br /> Daily Self Inspection* <br /> 1. Type and operation of vapor recovery equipment at the facility �j j w zY bj <br /> 2. How to Perform daily inspection of equipment <br /> 3. Procedures for non-com lianec equipment to out of order),complete maintenance log L57V9 <br /> Record Keeping (Maintenance, monitor, testing, wastes inspections, inventory, ermits, training, etc. <br /> 1. Location where records are keot I+j3 <br /> "2. T es of records maintained at the facility/length of time each record should be.kept <br /> EmployeS Signature Soc. Sec. #or Emp. ID# Dale <br /> Training Performed By M 3_-Vtj St4$g17 _1,,C_ 61V/3f <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 2i05 <br />