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f <br /> UNDERGRQUND STORAGE TANK SYSTEM <br /> DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br /> For use by Unidoes Member A(&encies or where approved by your Local Jurisdiction <br /> Authority Cited.- Title 23, Div. 3, Ch. 16 California Code of Regulations(CCR) <br /> Facility "same: Pilot Flying J #1017 <br /> Facility Site Address: 345 Roth Rd. Cite: Lathrop, CA 95330 <br /> Section 2715 of Title 23,California Code of Regulations, requires that Designated Underground Storage Tank Operators pro- <br /> vide training to facility employees who have responsibilities associated with the operation and/or maintenance of underground <br /> storage tank (UST) systems. This training must be provided by July 1, 2005, and every 12 months thereafter. For facility <br /> 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 <br /> facility employees present during operating hours must have current training. This training must include,but is not limited to, <br /> 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 /> El 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 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)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 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 /> Facility Employee N me Training Date Hire Date Employee ID # Trainer Name <br /> "g 251 v� �'t �� <br /> UN-061-1/1 www.unidocs.org 07/13/05 <br />