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-� �r Von 5 s <br /> Large Quantity Generator Hazardous Wast raining Record 1,2 <br /> Facility Name: Instructor Name: <br /> Sitr`�SaV\ <br /> S <br /> Facility Address: � Instructor Qualifications': <br /> i <br /> S106 'S- S4 Occrx�d) Lett« QAACteaW <br /> i Type(s)of Training:' —Classroom Leciure —Computer-Based _On-the-job <br /> f <br /> Employee Name: lob Title:' <br /> Job Description:' <br /> I <br /> Facillity personnel haaardous waste management and emergency response training, relevant to their job,within <br /> t 180 clays of hire and refreshed annually(Title 22 California Code of Regulations(T22CCR)§66265.16(b and c))' <br /> Rgguired topics Icheck off covered tonics) <br /> t 57 Hazardous waste contingency plan review and implementation,T22CCR§06265.16(a)(2) <br /> u Identification and segregation of incompatible hazardous waste or product,T22CCR§66265.16(a)(2) <br /> I 0 Prevention,mitigation,abatement and notification procedures,emergency equipment,and emergency systems,T22CCR§ <br /> r 662s�.gt;4ad(3) <br /> Other topics as applicable(check off covered topics) <br /> ilk procedures for using,inspecting.,repairing and replacing facility emergency and monitoring equipment,T22CCR§ <br /> i 66265.16(a)(3)(A) I <br /> EIN Key parameters for automatic waste feed, cut-off systems,T22CCR§66265.16(a)(3)(13) <br /> it Communications or alarm systems,T22CCR§ 6265.16(a)(3)(C) <br /> 0 Response to fares or explosions,T22CCR§66265.16(a)(3)(D) <br /> C Rfnponse to groundwater contamination incidents,T22CCR§66265.16(a)(3)(E) <br /> s Iff Shutdown o€operations,T22CCR§66265.16(a)(3)(F) <br /> 0 Self-protection measures,T22CCR§66265.16(a)(3)(G) <br /> 0 .accident prevention methods,T22CCR§66265.16(a)(3)(H) <br /> General awareness training required for all;.personnel, required every 24 months (T22CCR§66265.16(a)(4)(A)) <br /> Check:off covered topics <br /> E2 Description of the facility <br /> 0 Overview of the facility operations subject to hazardous waste control law and regulation <br /> �', Security and safety considerations related to hazardous waste <br /> Function-spetft itab training for all personnel involved with hazardous waste management activities, required <br /> ¢) every 24 months (T22CCwR§66265.16(a)(4)(3)) <br /> ( Gated:oft-covered topics <br /> C Overrriew of hazardous waste control law and regulation and site-specific procedures applicable to employee job tasks and <br /> functions. <br /> Training for personnel engaged in hazardous waste shipping, required triennially (T22CCR§66265.16(a)) <br /> Check off covered topics j <br /> Q Training commensurate with their responsibilities to meet the requirements of Title 49 Code of Federal Regulations§ <br /> 172.794. <br /> Signature of employee (or certified):' Date of Training: <br /> Page i of 2 version:Sept 22,2020 <br />