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NOV-22-2007 22:20 From: to:gess)( <br /> UNDERGROUND STORAGE TANK SYSTEM <br /> DESTGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br /> For use by l.;r+idac•.r,1}ember 91icncies Or inhere approved by yon,L,u Ol Jurisdiction <br /> Anihority Cited: rills 23, Ui, 3. C'h 16 Culifornia("ode of R gularrans(CC'R) <br /> Facility Na1nc: _ [��' kl-,z <br /> Facility Site Address: -1y�t rr�� _ city: <br /> Suction 2715 of Tits 23. Califonua Code of Regulations, requires that Designated Underground Storage Tank operators <br /> provide training to facility employees who h)rvc responsibilities associated with the operation and/or maintemm" of <br /> underground storage tank(I IST) systems. This training must he provided by July 1, 2005,and every 12 ownihs thereafter. <br /> For facility employees hired after July I,2005, thu initial training must be Provided within 30 dans of the dale of hire. At <br /> least one of the facility employees present during operating ituurs must have current training.This training must include,but <br /> is not limited to,the following items as specified in 23 CCR Sections 2715(})(1)and(2): <br /> ❑ operation of the UST system in a manner consistent with the facility's Hest Mmtagemeat Practices; <br /> O The employee's role with regard to UST monitoring equipment as specified in the written LIST Monitoring plan; <br /> O The employee's tole with regard to spills and overfills as specified in the written LIST Response Plan: <br /> ❑ Name(s)of contact person(s)for emergencies mid monitoring equipment alarms: <br /> ❑ For facilities rhat are not routinely staffed, facility anpluyvc responsibilities as specified in On:(reining program <br /> appmved by the local I1ST reguhuury agency. <br /> 23 CCR$2713(2)(3)requires that a list of employees who have been!mined by the Designated Underground S0.iragc 1 ank <br /> Uperator(s)be maintained on-site,or off-she at a readily-available location if annroved bYthe local a enc .and provided to <br /> rhe local agency gpon request.Completion of this form will satisfy UST training record keeping requirements.'the following <br /> employees have been trained as required by 23 CCR Sections 2715(})(1)and(2): <br /> ciiity Em Jlu Name. Traiain r Date Hire Date Traincr Name <br /> Vic <br /> S cue• / � o g <br /> "sem 1!- 1•o OS' <br /> (Conrinaed an reverse) <br /> 'If huod sour July 1.:005. <br /> TryiiMr moa Ix a current r)csq,nawd I IS I Orcrotor for ow fac wy a,d)¢lime of Irmnmf <br /> ltN�141-12 r..w,uniaon.n.y <br /> n1n3nJs <br />