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Q •.mrd -- n J� 15,2.0 Vb <br /> UNDERGROUND STORAGE TANK SYSTEM <br /> DESIGNA'FED OPERATOR FACILITY EMPLOYEE TRAIININiG RECORD <br /> For trse by Unidocs Xlem;wr 4�encies or where approved by your Local Jurisdiction <br /> Authority Cited: Title 23 1:iv. 3. Ch. 6 C alifnrniv Code of Reguiations ic(RRI <br /> Facility Name: Y�Z.t> <br /> Facility Site Address: r7 i I �= ' <br /> city; <br /> Section 2715 of Title 23, California Code of RL,mations, requires that Designaied Clnderground Storage Tank operators <br /> provide training to facility employees who hava responsi;�ilities associated with t't lopes Tun and,'or maintenance of <br /> underground storage tank (UST) systems. This training mus be provided by July 1,20015, and every 1' months thereafter. <br /> For facility employees hired after July 1, 2W5, &e initial training must be prop ided v.izhin 30 nays of the date of hire. At <br /> least one of the facility employees present during<.,perating kours must have current training.This training must include,but <br /> is not limited to,the following items as specified it 23 CCR!>ections 2715(1'0)and(2): <br /> ❑ Operation of the UST system in a manner consistent with the facility's Best Management Practices, <br /> ❑ The employee's role with regard to USI monitoring equipment as specified in�he written UST'Monitoring Plan; <br /> ❑ 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 emerges ies and m,.)nitoring equipment ai 's: <br /> ❑ For facilities that are not routinely staffed. facility employee responsibilities as specified in the training program <br /> approved by the local UST regulatory agency. <br /> 23 CCR§2715(t)(3)requires that a list of entploy.:es who ha,,e been trained by the Dc,igrtated t:nderground Storage Tank <br /> Operator(s)be maintained on-site,or off-site at a readily-avai'able location if iWIZroved by tht:local a enev and provided to <br /> the local agency upon request.Completion of this brm will satisfy UST training record keeping requirements.The following <br /> employees have been trained as required by 23 CCR Sections 27 i5(fk 1 i and(2?: <br /> -Eacili _Na_me n_l _--- 1�--nee �_._a-me <br /> —t ? eiRre Date' __ i <br /> 1--- <br /> lei <br /> F <br /> (Continued on revcrsef ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br /> is hire ii3er lu.`, 2001 <br /> 'Trainer must he a current Designated UST Operator fou the:.,_ility at the WIL of trairung. <br /> UN-061-iR 07113!05 <br />