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EMPLOYEE TRAINING VERIFICATION <br /> Name of Company: 7-Eleven Store <br /> Street Address: <br /> City,Zip Code: �1j-,�'.T� ) / /'✓� E7- <br /> Employee Name(s) (Print) <br /> I acknowledge that I have received and understand environmental compliance training in <br /> the following areas lease initial or mark N/A for notapplicable): <br /> Initial Date <br /> Hazardous Materials Management Hazardous Materials Business Plan HMBP <br /> 1. Which materials at the facili are hazardous Carbon Dioxide, Propane) (� <br /> 2. Where these materials are stored. Z <br /> 3. How are these materials handled and stored. � <br /> 4. What are Safe Data Sheets SDS and where the are kept at the store '_k <br /> `� <br /> 1 <br /> 5. Pro er use of the Fire Extinguishers. <br /> � <br /> 6. Training topics included in the HMBP(attached),review of SDSs and the emergency <br /> res onse rocedures. Da )� <br /> S ill and Leak D-----se (Spill Response Plan <br /> 1. Location of s ill res onse equipment <br /> 2. Location of emergency contact list 1 2a 74 <br /> 3. Location of the shut off switches and utility shut offs. <br /> Daily Self Ins ection <br /> 1. Are the tanks &cylinders secured? <br /> 2. How to erform daily inspection of equipment °4 ,2'09 <br /> 3. Procedures for non-com liance equipment to out of order , com Tete maintenance to r g <br /> 1� <br /> Record Kee in aintenance, monitor, wastes, irasasecti�ns, invento. , ermits, trainin , etc. <br /> 1. Location where records are ke t M <br /> 2. Types of records maintained at the facility/le­nh of firm each,record should be ke t <br /> Em yee S' natur — y______..� g <br /> 3mployee Ntiumber Date <br /> Em oyee igna e Employee Number Date <br /> m to ee Signature Employee Number Dat9 <br /> Em p y e Signature Employee Number <br /> S <br /> Training verified b /nip �/ � 0�1� Date <br /> Fra isee Name <br /> D to <br /> MAINTAIN THIS FORM THE ENTIRE TIME THE EMPLOYEE WORKS AT THE FACILITY <br />