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Large Quantity Generator Hazardous Waste Training Record s, 2 <br /> Facility Name : p Instructor Name : <br /> Facility Address : Instructor Qualifications3 : <br /> 9s�aote 94?14 r f( 'A �e C0 ) V <br /> Type ( s ) of Training : 4 _ Classroom Lecture _Computer- Based ,oOn -the-job <br /> Employee Name : / Job Title : 5 <br /> Job Description : 6 <br /> Facility personnel hazardous waste management and emergency response training, relevant to their job, within <br /> 180 days of hire and refreshed annually (Title 22 California Code of Regulations (T22CCR ) § 66265 . 16( b and c) ) ' <br /> Required topics ( check off covered topics ) <br /> ;2- Hazardous waste contingency plan review and implementation , T22CCR § 66265 . 16 ( x ) ( 2 ) <br /> XIdentification and segregation of incompatible hazardous waste or product, T22CCR § 66265 . 16 ( a ) ( 2 ) <br /> Prevention, mitigation, abatement and notification procedures, emergency equipment, and emergency systems, T22CCR § <br /> 66265 . 16 ( x ) ( 3 ) <br /> Other topics, as applicable ( check off covered topics ) <br /> ❑ Procedures for using, inspecting, repairing and replacing facility emergency and monitoring equipment, T22CCR § <br /> 66265 . 16 ( a ) ( 3 ) (A) <br /> ❑ Key parameters for automatic waste feed cut-off systems, T22CCR § 66265 . 16 ( a ) ( 3 ) ( B ) <br /> ❑ Communications or alarm systems, T22CCR § 66265 . 16 ( a ) ( 3 ) ( C) <br /> 0 Response to fires or explosions, T22CCR § 66265 . 16 (a ) ( 3 ) ( D ) <br /> ❑ Response to groundwater contamination incidents, T22CCR § 66265 . 16 ( a ) ( 3 ) ( E ) <br /> ❑ Shutdown of operations, T22CCR § 66265 . 16 ( a ) ( 3 ) ( F ) <br /> ❑ Self- protection measures, T22CCR § 66265 . 16 ( a ) ( 3 ) ( G ) <br /> ®.- 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 /> Eg—Description of the facility <br /> gil�Overview of the facility operations subject to hazardous waste control law and regulation <br /> ❑ Security and safety considerations related to hazardous waste <br /> Function -specific job training for all personnel involved with hazardous waste management activities, required <br /> every 24 months (T22CCR § 66265 . 16 ( a ) (4 ) ( B ) ) <br /> Check off covered topics <br /> ❑ Overview 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 <br /> ❑ Training commensurate with their responsibilities to meet the requirements of Title 49 Code of Federal Regulations § <br /> 172 . 704. <br /> El <br /> Sign �re of employee ( or rtified ) : $ Date of Training : <br /> poll <br /> 1� Z ��- <br /> Page 1 of 2 version : Sept 22, 2020 <br />