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,08/13/2009 04:18 2098873408 KAREN ARNAIZ PAGE 02/06 <br />UNDERGROUNI) STORAGE TANK SYSTEM <br />DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br />For use by Unidocj Member Agencies or where approved by your Local Jurisdiction <br />Authority Cited: Title 23, Div. 3, Ch 16 California Code of Regulations (CCR) <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 and/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 date of hire. At 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 />XOperation 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 role with regard to spills a> d overfills as specified in the written UST Response Plan-, <br />Name(s) of contact person(s) for emergencies and monitoring equipment alarms; <br />0 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 Underground Storage Tank <br />Operator(s) be maintained on-site, or off-site at a readily -available location if approvedand 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 />lacifity <br />Training Date <br />Hire Date <br />Trainpr Name2 <br />12J I <br />(Continued on reverse) <br />If hired after July 1, 2005. <br />Trainer must be a current Desienated UST Opendnr for the facility at the time of training. <br />FJN-%l - 1/2 . www.uxd4m.org 07113/05 <br />