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SAN JOAOUIN <br /> C '= U "] Y <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 the position of each employee. The use of <br /> this sign-in sheet is optional. The facility can choose to use any acceptable form to record the <br /> training(s). <br /> Employee(s)Training Sign In Form <br /> Course Name: Date: <br /> 602 N ENc &AA1 TeA/.v -4 /Z ,202 <br /> Facility Name: Instructor's Name: <br /> /// P Gs3 <br /> Facility Address: CERS ID: <br /> i 4 Z� ZIAe eltl 176(9 eA- <br /> Type(s) of Training: ❑ Classroom Lecture n Tabletop Exercise ❑ Hands on <br /> / Field Exercise Safety Meeting <br /> Summary of Training Topics Discussed: <br /> P/4-Z- iy0T/F/�t17/0�/ p2O CCC <br /> S1,2/ 1L eCS?pA/SLF 4/?CCe-0() 0tC <br /> REV. 11/18/2019 HMBP Program <br />