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CALIFORNIA ON-SITE STATION TRAINING FORM - NEI V EMPLOYEE TRAINING VERIFICATION <br /> Site Number i Z425- Dealer <br /> Street Address r- r <br /> City.Zip Code_ —*IYD¢Z <br /> Employee Name(Print)_ <br /> I acknowledge that I have received and understand le mvironmental compliance training in <br /> the following areas please initial <br /> _ T Initial Date <br /> UST S sff <br /> aHons _ -- <br /> 1. The t ations of the tanks at the station <br /> 2. The t ation of the leak detections stem y <br /> 3. For electronic monitors dailymonitoringcheck to and alarm to 4 11 <br /> Hazardous Materials Management Hazardous Materials Mai a ement/$uslness_Plan <br /> 1. Which materials at the station aro hazardous <br /> 2. Where these materials are stored <br /> 3. How these materials are to be handled stored,and Ai..­A of t� <br /> 4. What Material Safet Date Sheets MSDS are and where they are k tat the station <br /> 5. Training topics included in the HMMP, including review of MSDSs j nd the emergency <br /> res once Ian <br /> y <br /> Waste Management Procedures _ � <br /> 1. Procedures in the service bay e <br /> 2. The correct management for products in the station <br /> 3. Proper labeling of wastes <br /> 4 The importance of manifesting or having a receipt for all hazardous Z Laterials that leave the <br /> site <br /> AS111 and Leak Res onsa S�»Il Res onee Pian cation of s>ill rca[ion of a ill or leak contact list,re ortin roceduros ri r r <br /> 3. Location of emerlLancy fuel shut-off switch s� r <br /> Inventory Reconciliation It 01 <br /> I. How to perform accurate inventory control ,, , , ,r <br /> J.Z. F0110w-up of gasoline inventog overage/shortage variance <br /> 3. Reporting and maintaining inventory records r �� <br /> Daq Self Ins ectlon* <br /> l. T e and operation of valor recovery equipment at_the facilit �l r r <br /> 2. How to perform HY inspection of equipment <br /> 3. Procedures For non-compliance equipment to out of order),com lot maintenance to <br /> Record Kee in aintenance monitor tatting wastes ins ec Ions invento�ipermlq t alnln etc. 7 <br /> 1. Location where records are ke t <br /> 2. T es of r c s maintaine t the facilit /tan h of time each re should be kept /Y <br /> Employee Si nature i Social Sec.Nun bar Date t L <br /> Training verified byy�y�,y�L 1 r <br /> Dealer/Instructor Date <br /> For facilities within the jurisdiction of the South Coast Air Quality Mai agoment District,the training provided to <br /> employees must be certified by the agency. <br /> MAINTAIN TAIL vnrrnc TTTs <br /> t•A "d WH SZ: To 119Z-SZ-170 <br />