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HAZARDOUS MATERIALS BUSINESS PLAN (HMBP) <br /> EMPLOYEE TRAINING RECORD <br /> FACILITY NAME: . <br /> TRAINING DATE: o 5- Az .I <br /> Training must be provided upon hiring and annually thereafter <br /> Employees of this facility were trained on this day in accordance with the Facility's HMBP Employee <br /> Training Plan, including, but not limited to, familiarity with the following: <br /> Facility's HMBP emergency response plans and procedures in the event of a release or threatened <br /> release of a hazardous material, including all of the following: <br /> (A) Immediate notification contact information for the appropriate local emergency response <br /> personnel, the State Office of Emergency Services, and the unified program agency. <br /> (B) Procedures for the mitigation of a release or threatened release to minimize any potential <br /> harm or damage to persons, property, or the environment. This includes methods for safe <br /> handling of hazardous materials present, and proper use of personal protective and emergency <br /> response equipment that is on site. <br /> (C) Evacuation plans and procedures, including immediate notice, for the business site. <br /> The emergency response plans and procedures, hazardous materials inventory, and facility map <br /> reported in this facility's HMBP, and hazardous materials Safety Data Sheets shall be readily available <br /> to personnel of the business. How to access this information was discussed with employees during <br /> this training. <br /> EMPLOYEES PRESENT DURING THIS TRAINING INCLUDE: <br /> NAME: &tL <br /> n�� SIGNATURE: at <br /> NAME: —Taws C_ .-:5- r G tAZ SIGNATURE: s-- �— <br /> NAME: SIGNATURE: <br /> NAMSIGNATURE: <br /> NAME: SIGNATURE: <br /> NAME: SIGNATURE: <br /> NAME: SIGNATURE: RF <br /> Employee training records shall be made available for a minimum 0;heoel years <br /> OCT 19 2016 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br />