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SAW-10AQUIN <br /> CO SNI ry <br /> Environmental Health Department <br /> Hazardous Materials Business Plan (HMB) Training Program <br /> Per Health and Safety Code 25505 ( a ) (4, training for all employees and annual training, including <br /> refresher courses, shall include familiarity with the facility's Emergency response plans and <br /> procedures in the event of a release or threatened release of a hazardous material . Training <br /> shall cover, but not limited to, all of the following: <br /> (A) Immediate notification contacts to the appropriate local emergency response personnel and <br /> to the unified program agency. <br /> ( B) Procedures for the mitigation of a release or threatened release to minimize any potential <br /> harm or damage to persons, property, or the environmentl. <br /> ( C) Evacuation plans and procedures, including immediatenotice, for the business site. <br /> These training programs may take into consideration of each employee . The use of this sign -in <br /> sheet is optional . The facility can choose to use any acceptable form to record the training(s) . <br /> Employee(s) Training Sign In Form <br /> Course Name : Date : q /.g / Zo <br /> Facility Name : Instructor' s Name : <br /> \ VS-r\ VS S U Yo S e o <br /> Facility Address : CERS ID : <br /> VI 30 Uon W\ f A suklon 45 20 10 50 9 y <br /> Type (s) of Training : ❑ Classroom Lecture ❑ Tabletop, Exercise rY Hands on <br /> ❑ Field Exercise N Safety Meeting <br /> Summary of Training Topics Discussed : <br /> - ? to IN v\&Vv ( G61R, 16i <br /> \- v` Cl t r.D 1m <br /> 1,nw Wj JDyc— \k <br /> t, <br /> REV. 11/18/2019 HMBP Program <br /> r <br />