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signated Underground Storage Tank(UST)%,perator <br /> Facility Employee Training Record <br /> iilName;Safeway ---�—__ — <br /> FacddyAddress 1804 West 11Th Street , <br /> Parson Conducting Training Dave Thomas et Trac CA 95376- <br /> Pnone(408)971-2445 <br /> Date <br /> ICC C?n _5n.,�kSz4P(1td.L Exp Date <br /> Instructions <br /> Section 7215 of Title 23,California Code of Regulations,requires that Designated Underground Storage Tank Operators provvle trammg � <br /> sociated with the operation and/or maintenance of underground storage <br /> to facility employees who have responsibilites astank LUST} <br /> systems This training must be provided by July 1.2005,and every 12 months thereafter For facility employees hired after July 1.2M5. <br /> the initial training must be provided within 30 days of the date of hire At least one of the facility employees present during operating <br /> r hours must have current training.This training must include,but is not limited to,the following items as specified in 23 CCR Sections <br /> 2715(1 and(2) <br /> IR Operation of the UST system in a manner consistent with the facility's Best Management Practices, <br /> 4 The employee's role with regard to UST moitoring equipment as specified in the written UST Monitoring Plan, <br /> R The employee's role with regard to spills and overfills as specified in the written UST Response Plan, <br /> ® Name(s)of contact person(s)for emergencies and monitoring equpment alarms, <br /> 1 C For facilities that are not routinely staffed,facility employee responsibilities as specified in the training program approved <br /> I by the local UST regulatory agency <br /> r <br /> f 23 CCR 2715(f)(3)requires that a list of employees who have been trained by the Designated Underground Storage Tank Operator(s) <br /> be maintained on-site,or off-site at a readily-available locaion if approved by the local agency,and provided to the local agency upon <br /> request Completion of this form will satisfy UST training record keeping requirements The following employees have been trained II <br /> as required by 23 CCR Sections 2715(f)(1)and(2): <br /> Training Report <br /> Employee Name Hire Date Trained DatE Trainer Name Comments Expire Date <br /> Varta LARA / / 3/10/10 I, 3110!11 1 <br /> 1VVM;a— Kaufman / / 3/10/10 Dave Thomas 3!10111 <br /> 5119!11 <br /> Marcus Navejas / / 5/19/10 6!11111 <br /> Maga T Cagadas / / 6/11/10 -- 8124 11 <br /> LUIS �asteiiarirs / / 8/24/10 Dave Thomas <br /> —. — - 9124111 <br /> !R.Icnaro R Martinez / / 9/24/10 Dave Thomas 9124111 <br /> Jacob 0111mar / / 9/24/10 Dave Thomas 3114112 <br /> Davlda Pando / / 3/14/11 Dave Thomas <br /> I n�liCi Ilrrll {Z CINtYI <br /> �atrnt�l. <br /> int'°r <br /> C` p date of <br /> PAI Lk <br /> �-, <br /> 4�1}l L� £O A- ,- <br /> M iso, <br /> ti� t <br /> ; 11z - - <br /> 730 <br />