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06/05/15 03:15PX HP LASERJET FAX 2099551865 P.05 <br />0 0 RECEIVEL <br />UNDERGROUND STORAGE TANK SYSTEM <br />DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING i&MM150' <br />For use by Unidoay Member Agencie-,; or Where approved by your Local Juri.vdicaon <br />Aulhori(V Cited: 7ide 23, Div, 3. Ch. Id California Code q1')?egujd(i0nS WMVIRONMENTAL <br />0 Y <br />Facility Name: HF -A' "?=r)j0TjjrN�-r <br />Facility Site Address; city.. <br />Section 2715 of Title 23, California Code of Regulations, requires that Designated Underground Storage Tank Operators <br />provide training to facility employee's who have responsibilities associated with the operation and/or maintenance of <br />underground storage tank (UST) systems, This training mug be provided by July 1, 2005, and every 12 months thereafter. <br />for fhcility employees hired after July 1, 7005, the initial training must be provided within 30 days of the date of hire. At <br />IC061 One of the facility eniployces present during operating hours mutt have current training. This training must include, but <br />is not litnitcd to, the Following items as specified in 23 CCR Sections 2715(f)(1) and (2): <br />0 Operation Of the UST system in a manner consistent with the facility's Best Management Practices; <br />0 The employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring Plan; <br />0 The employee's role with regard to spills and overfills as specified in the written UST Response Plan; <br />0 Name(s) of contact person(s) for emergencies and monitoring equipment alarms; <br />C3 For facilities that arc not routinely stafT4 facility employee responsibilities as specified ill the training program <br />approved by the local UST regulatory agency, <br />221 CCR § 2715(f)(3) requires 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_aTp_rqyL, _e4_by he y_Iocgl ago,, and provided to <br />the local agc"OY UPOD request, Completion of this ferns will satisfy UST training record keeping requirements, The following <br />employees have been trained as required by 23 CCR Sections, 27 1 5(t)(1) and (2): <br />(Confinued on reverse) <br />if hircd anor July 1, ZW5, <br />'Trahwt tnUst be a current oftignated USI ()pantor for the facility at jjW turas of tini"ing, <br />www.uni4m.org OWN <br />