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68/07/2009 09:29 12093341873 FLAGCITY CHEVRON PAGE 03/04 <br />U"ERGROUND STORAGE TANK SYSTEM <br />DESIGNATED OPERATOR FACILITY EMPLOYEE TRAMING RECORD <br />For use by Unidocr Member Agencies or w/rere Mpraved IV your Local Jurfadictinn <br />Authority Cited Title 23, Div. 3, Ch- 16 Calybrnra Code ofRegulatrons (CCR) <br />FadW Name:� ( ' f ZI 9! J CQ ri ---- <br />]F'aciility Site .Address City: J=u � <br />Section 2715 of Title 23, California Code of Regulations, regWres that Designated Underground Storage Tank Operators <br />provide training to facility employees who have rrsponsibiili m associated with the operation and/or mairrtensnce of <br />underground storage tack (UST) gysterns. This training must be pmovided by July 1, 2005, and every 12 months *ereaftm. For <br />facility employe" hired after July 1, 2005, the initial training, must be provided within 30 days of the date of hire. At least one <br />of the facility employees present during operating, hours must have cutrnnt training. This training must include, but is not <br />limited to, the following items as specified in 23 CCR Sectiotls 2715(f)(1) and (2)- <br />23 Operation of the UST system in a manner eonsiswot with lite facility's Nest ManagemeW deer; <br />® The employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring Plan; <br />0 The employee's role with regard to spills and overfills as specified in the written UST Response Plan; <br />0 Name(s) of contact person(s) for emergencies and monitoring equipment alarms; <br />d For facilities first are not routinely staffed, fig-lity employee responmbilities as specified in the training program <br />approved by the local UST tt' datory agency <br />23 CCR § 2715(f)(3) requires that a list of employees who have been trained by the Designowd. Underguund Storage Tank <br />Operators) be maintained on-site, or off-site at a headily -available location i ay �_145�1 aeoRtc-y and provided to <br />the local agency upon request Complefiion of this form will satisfy UST brmiuring record keeping requirement& The fnilowing, <br />employees have been trained as requited by 23 CCR Sections 27150(1) and (Z)_ <br />if hired afbdr July X, ?ODS. UST for for ft facility at *,e time of traininX <br />Trainer must be a gnrent L1eSi�A►p1 �� <br />ION -461 - 1/1ctww.nnldnea.org 07/13/05 <br />