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SAN JOAQUIN <br /> tP LT_. —COUNTY <br /> "�3�' Grrntness t�rocvs f<•r <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 environment. <br /> (C)Evacuation plans and procedures,including immediate notice,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: <br /> Facility Name:S"`IJY S#WDUA LkES Instructor's Name: <br /> 5 nou 0. <br /> Facility Address: 1.7367 W y0.5*_rvi l+GL CERS ID: <br /> �idc� �3a5 <br /> Type(s)of Training: ❑Classroom Lecture q Tabletop Exercise D Hands on <br /> u Field Exercise ❑Safety Meeting <br /> Summary of Training Topics Discussed: <br /> REV.11/18/2019 HMSP Program <br />