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F M <br /> UNDERGROUND STORAGE TANK S YSTE <br /> DESIGNATED OPE TOR FACILITY EMPLOYEE T INING ECQ <br /> RD <br /> For use by Unidocs tll'ember Agencies or where approved by your Local Jurisdiction <br /> Authority Cited: Title 23, Div. 3, Ch. 16 California Code of Regulations(CCR) <br /> Facility Name: 7 :f1c _!, <br /> City: 71,21 C,Z <br /> Facility Site Address: �7� = A <br /> Section 2715 of Title 23, California Corte of Regulations, requires <br /> thatassoDesi with Undergrounorage the ration and/or Tmaintenance koperators <br /> provide training to facility employees who have responsibilities <br /> underground storage tank('UST) systems. of <br /> "This training must be provided by July 1,2005, and every 12 months thereafter.For <br /> ided within 30 days the date of hire. <br /> facility employees hired after July 1,2005,the initial training must be provAt least one <br /> of the facility employees present during operating hours must have current training. This training must include, but is not <br /> limited to,the following items as specified in 23 CCR Sections 2715(f)(1)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 UST monitoring equipment as specified in the written UST Monitoring Plan; <br /> ❑ The employee's rcde with regard to spills and overfills as specified in the written UST Response Plan; <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)requ�.res that a list of employees who have been trained by the Designated Underground Storage Tank <br /> Operator(s)be maintained on-site,or off-site at a readily-available location if approved by the local agency,and provided to <br /> the local agency upon request. Completion of this form will satisfy UST training record keeping requirements.The following <br /> employees have been trained as required by 23 CCR Sections 2715(f)(1)and(2): <br /> Facilit Employee Nance Trainin Date Hire Datet Trainer NaeZ <br /> 0 .2 <br /> (Continued on reverse) <br /> 1 if hired after July 1,2005. <br /> 2 Trainer must be a current Designated UST Operator for the facility at the time of training. <br /> 07/13/05 <br /> www.unidoes.org <br /> UN-061-1/2 <br />