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ON-SITE TRAININGFppORM - <br />Y� <br />P <br />Name of Company: S +(3 C,y® r') <br />Street Address: <br />City, Zip <br />Employee Name (Print <br />r 6 b.5 <br />® G,k j� c3\n <br />NEW EMPLOYEE TRAINING VERIFICATION <br />,t <br />LA "A) <br />o�7�a <br />4 add <br />I acknowledge that I have received and understand environmental compliance training in <br />the following areas (please initial or mark N/A for not applicable): <br />Employee Signature <br />Training verified by <br />Social Sec. Number <br />Instructor <br />1 .. <br />ate <br />Date <br />Initial <br />Date <br />UST System Operations <br />1. The types and locations of the tanks at the facility <br />,% <br />1)' >" M2 <br />2. The type and operation of the leak detections stem <br />, <br />j �/1 <br />3. For electronic monitors, daily monitoring check log and alarm log <br />„l, <br />%/iq'j <br />Hazardous Materials Management Hazardous Materials Management/Business Plan <br />1. Which materials at the facility are hazardous <br />2. Where these materials are stored <br />14, /hI% <br />3. How these materials are to be handled, stored, and disposed of <br />4 <br />/ 4j 41L <br />4. What Material Safety Data Sheets (MSDS) are and where they are kept at the facility <br />. ^0 <br />bb 41 R <br />5. Training topics included in the HMMP, including review of MSDS and the emergency <br />res onse plan <br />Spill and Leak Response (Spill Response Plan <br />1. Location of spill response equipment <br />2. Location of spill or leak contact list, reporting rocedures <br />A. <br />3. Location of emergency fuel shut-off switch <br />4 I <br />Inventory Reconciliation <br />1. How to perform accurate inventory control <br />M <br />2. Follow-up of gasoline inventory overage/shortage (variance) <br />/A, <br />! 2 d Z <br />3. Reporting and maintaining inventory records <br />tie A, <br />'Z <br />Daily Self Inspection* <br />/4 <br />1. Type and operation of vapor recovery equipment at the facility <br />/19 <br />2. How to perfonn daily inspection of equipment <br />" 0 Z <br />3. Procedures for non-compliance equipment to out of order), complete maintenance log <br />Ile ✓%> <br />/q <br />Record Keeping Maintenance, monitor, testing, wastes, inspections, inventory, permits, traim g, etc.) <br />1. Location where records are kept <br />I J/rf % <br />am.0/71 <br />Z <br />2. Types of records maintained at the facility/ length of time each record should be ke t <br />I NoAt/ <br />II 'Z <br />Employee Signature <br />Training verified by <br />Social Sec. Number <br />Instructor <br />1 .. <br />ate <br />Date <br />