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02�J07/2012 15:17 12099438661 CHP STOCKTON 11 UST System Designated C"rator Facility,Employce Training Record — Page 2 of 2 UNDERGROUND STORAGE TANK SYSTEM A A L ces A �fl I Rizid I ( I My W 61 %Wi 61 k- li a 7R 311 V�Vt W-ITVT.T*T,M- Facitity Site Address: 3330 N. Ad Art Rd — City- Stockton PAGE 03/03 Section 2715 of Title 23, California Code of Regulations, requires that Designated Underground Storage Tank Operators provide training to facility employees who have responsibilities associated with the operation and/or maintenance of underground storage tank (UST) systems. This training must be provided by July .1, 2005, and every 12 month,-, thereafter, For facility employees hired after July 1, 2005, the initial training must be provided within 30 days of the date of hire. At least one of the -facility employees present during operating hours must have current training. This training must include, but is not limited,to,.ffie fallowing item as,-sp=iBzdiv23 CCR Sections 2715(f)(1) and (2): Operation of the UST system in a manner consistent with the facility's Best Management Practices, The employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring Plan; The employee's role with regard to spills and overfills as specified in. the writ -ten UST Response Plan; Name(s) of contact person(s) for emergencies and monitoring equipment alarms; For facilities that are not routinely staffed, facility employee responsibilities as specifled in the training program approved by the local UST regulatory agency. 23 CCR § 2715(f)(3) requires that a list of employees who have been trained by the Designated Underground Storage Tank Operator(s) be maintained on-site, or, off-site at a readily -available location if Wrovedby the local ggggggy, and provided to the local agency upon request Completion of this form will satisfy UST training record keeping requirements- The following employees have been trained as required by 23 CCR Sections 2715(0(1) and (2): 5. Facility Employee Name Trajniqg Date Hi jre Date' Trainer Name r,, YA\A O.K. 4,7 1 If hired after July 1, 2005. 1 Trainer must be a current Designated UST Operwor for the facility at the time of training. 2/2 07/1.3/05