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REVD QCT 2 3 2012 UNDERGROUND STORAGE TANK SYSTEM DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD pot use by L•'njdocr Member Agencies or Where approved by your Local Jurisdiction .d urhorin`Cited: Titla 213, Dit, 3. Ch 16 California Code of Regulations(CCR) Facility Name: •— _ _ -- —.._,•—^. . Facility Site Address: _1� — pity• � ._.�_.... --- Section 2715 of Title 23, California Code of Regulations, requires that Designated Underground Storage -tank Operators provide training to facility employees who have responsibilities associated with the operation and/or maintenance of underground stbrage tart:(UST)systems.This training must be provided by July 1,2005,and every 12 months thereafter. For facility employees hirod after July 1,2005,the initial training must be provided within 30 days of the date of hire.At least one of the facility employees present during operating hours must have current training. This training must include, but is not lirnite to,the following items as specified in 23 CCR Sections 2715(f)(1)and(2), Operation of the USI'system in a mariner consistent with the facility's Best Management Practices; The erpployec's role with regard to UST monitoring equipment as specified in the written UST Monitoring Pian: The employee's role with regard to spills and overfills as specitled in the written UST Response Plan. Name(s)of contact persons)for emergencies and monitoring equipment alarms; - ❑ For facilities that are not routinely staffed,facility employee responsibilities as specified in the training progriun approved by the local JUST regttlatory agency. 23 CCR§2715(f)(3)requiros that a list of employe4s who have been trained by the Designated Underground Storage"hank operator(s)be maintaLted on-site,or off-site at a readily-availably*ationif aot roved ttieocal agency,and provided to the local agency upon request.Completion of this forth will satisfy UST training record keeping requirements-The following employees have been trained as required by 23 CCR Sections 2715(1)(1)and(2): Patelli _Fm to ee N me _ Trainia�Datg Hire Date "train r Name; ^_ �- l (Cor4inued on reverse) `It'{ttttd aftct full'{.=t1u5 ' r rrairkr must Iso a cur.cnr Dcstgnaicd LAS f Operator Ibr the facility:u the umt 01 training www.unitlUcx.,�r� 0'tf!/OS (IN-06t-112 ` TO/TO 39dd SN3SIndo d031NVW E89ZbZ860Z 90:61 ZTOZ/bZ/OT