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= � SANoJ0A0UIN <br /> —COUNTY— <br /> Environmental Health Department <br /> Hazardous Materials Business Plan (HMBP)Training Program <br /> Per Health and Safety Code 25505(a)(4),training for all employees and annual training, <br /> including refresher courses,shall include familiarity with the facility's Emergency response <br /> plans and procedures in the event of a release or threatened release of a hazardous material. <br /> Training 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: t.. Date: I0 <br /> � _p,3 <br /> Facility Name: {� Instructor's Name: <br /> Facility Address: ��. X%A 111`'iV_ S.; CERS ID: e <br /> C,�-�O � 01-�a• <br /> Type(s)of Training: ❑Classroom Lecture ❑Tabletop Exercise ❑ Hands on <br /> ❑ Field Exercise &2ftafety Meeting <br /> Summary of Training Topics Discussed: <br /> Sv➢LC '7 -pC�9,➢C-0 A-.-+tom \..��2Y"c <br /> REV.11/18/2019 HMBP Program <br />