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CALIFORNIA ON-SITE STATION TRAINING FORM - NEW EMPLOYEE TRAINING VERIFICATION <br /> Site Number Dealer <br /> Street Address 113 I\J L pQ x A- p o S'( <br /> City,Zip Code <br /> Employee Name(Print) L U S V/ L f J-J f _ <br /> I acknowledge that I have received and understand environmental compliance training in <br /> the following areas (please initial): <br /> Initial Date <br /> UST System Operations <br /> 1. The types and locations of the tanks at the station L V s 6 <br /> 2. The type and operation of the leak detection system 1_ V <br /> 3. For electronic monitors,daily monitoring check log and alarm log <br /> Hazardous Materials Management(Hazardous Materials Management/Business Plan) <br /> 1. Which materials at the station are hazardous V <br /> 2. Where these materials are stored L V <br /> 3. How these materials are to be handled,stored,and disposed of <br /> 4. What Material Safety Data Sheets(MSDS)are and where they are kept at the station If it <br /> 5. Training topics included in the HMMP, including review of MSDSs and the emergency L <br /> response plan <br /> Waste Management Procedures <br /> 1. Procedures in the service bay L- <br /> 2. The correct management for products in the station L-V <br /> 3. Proper labeling of wastes 1,- <br /> 4. The importance of manifesting or having a receipt for all hazardous materials that leave the V <br /> site <br /> Spill and Leak Response(Spill Response Plan) <br /> 1. Location of spill response equipment V <br /> 2. Location of spill or leak contact list, reporting procedures L <br /> 3. Location of emergency fuel shut-off switch L V ' <br /> Inventory Reconciliation <br /> 1. How to perform accurate inventory control L << <br /> 2. Follow-up of gasoline inventory overage/shortage(variance) L!/ <br /> 3. Reporting and maintaining inventory records <br /> Daily Self Inspection* L-V <br /> 1. Type and operation of vapor recovery equipment at the facility L\/ <br /> 2. How to perform daily inspection of equipment 1, -v <br /> 3. Procedures for non-compliance equipment(tag out of order),complete maintenance log LV <br /> Record Keeping(Maintenance, monitor,testing,wastes,inspections, inventory, permits, training, etc.) <br /> 1. Location where records are kept I Lel -4 <br /> 2. TyWs of rgeords maintained at the facility/length of time each record should be kept J L V <br /> U0-ySqy�-41' 0� s . <br /> Employee Signature _p.�.� Social Sec.Number D to <br /> Training verified by �c>-`V�� d . <br /> Dealer/Instructor Date <br /> * For facilities within the jurisdiction of the South Coast Air Quality Management District, the training provided to <br /> employees must be certified by the agency. <br /> MAINTAIN THIS FORM THE ENTIRE TIME THE EMPLOYEE WORKS AT THE FACILITY <br /> 00457(REV.01!2000) <br />