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AUG-21-2008 02:09 FROM:SCKAASF 209-983-5394 TO:2094683433 PAGE:07 <br /> 0 <br /> UNDERGROUND STORAGE TANK SYSTEM <br /> DESIGNATED OPERATOR FACILITY EMPLOYEE T ININC; RECORD <br /> For use by Unidocs Member Agencies or where approved by your Local Jurlsdicrioj) <br /> Aarhoriry Cited: Title 23, Div, 3, Ch. 16 California Code ofRegularions <br /> Facility Name: C-;T0 e--rb0 A AS.r <br /> Facility Site Address: 2000 'nQ ? City: <br /> Section 2715 of Title 23, California Code of Regulations, requires that Designated Underground Storage Tank Operators <br /> provide training to facility employees who have responsibilities associated with the operation anal/or maintenance of <br /> underground storage tank(UST)systems, This training must be provided by July 1,2005,and every 12 months thereafter. For <br /> facility employees hired after July 1,2005,the initial training must be provided within 30 days of the datt;of hire, At least one <br /> of the facility employees present during operating hours must have current training. This training muss. include, but is not <br /> limited to,the following items as specified in 23 CCR Sections 2715(f)(1)and(2): <br /> R Operation of the UST system in a manner consistent with the facility's Best Management Practic.ca; <br /> W The employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring Plan; <br /> The employee's role with regard to spills and overfills as specified in the written UST Response flan; <br /> Name(s)of contact person(s)for emergencies and monitoring equipment alarms, <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(f)(3)requires that a list of employees who have been trained by the Designated Undergro'.,Lnd Storage Tank <br /> Operator(s)be maintained on-site,or off-site at a readily-available location if.approved by the locai agency;and provided to <br /> the local agency upon request.Completion of this form will satisfy UST training record keeping,requirem::nts.The following <br /> employees have been trained as required by 23 CCR Sections 2715(f)(1)and(2): <br /> Facility Employee Name Training]Date Hire Date Trainer Name y <br /> - � •.: � Z/ .r�D7 ��►� gads" ���^ . <br /> r( rzArLt�u NAr.Axp% �v <br /> It" Sal pfa.c ZOoU <br /> (Continued on reverse) <br /> 'If hired after July 1,2005. <br /> '-Trainer must be a current Designated UST Operator for the facility at the time of training. <br /> 11N-061-1/2 www,unlducs,org 07/13/05 <br />