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HAZARDOUS MATERIALS BUSINESS PLAN <br /> FACILITY EMPLOYEE TRAINING RECORD <br /> For use by Unidocs A4ember Agencies or where approved by your Local Jurisdiction <br /> Authority Cited: California Health and Safety Code Chapter 6.95(HSC); Title 19 California Code of Regulations(CCR) <br /> Facility Name: D, ,' Co =�=— Cf '� Cf <br /> Site Address: L 5—f a P--F DV City: A <br /> California Health and Safety Code §25507(a)and Title 19 California Code of Regulations §2651(a) require that a <br /> Hazardous Materials Business Plan (HMBP)facility implement its HMBP, including the training plan specified in <br /> HSC §25505(a)(4)and 19 CCR §2659(a)(4). Taking into account the position of each employee,training for new <br /> employees must be provided in safety procedures in the event of a release or threatened release of a hazardous <br /> material. Annual refresher training is required. This training must be documented electronically or by hard copy <br /> records. Training records for the past three years must be kept available for inspection. <br /> HMBP training must include,but is not limited to,the following: <br /> [/Methods for safe handling of hazardous materials; <br /> [Identification of areas of the facility and mechanical or other systems that require immediate inspection or <br /> dsolation because of their vulnerability to earthquake related ground motion; <br /> Evacuation plans and procedures, including immediate notification, for the facility; <br /> entification of local emergency medical assistance appropriate for potential accident scenarios; <br /> lotification of local emergency response personnel, the Unified Program Agency, the California Emergency <br /> 21 Eanagement Agency,and persons within the facility who are necessary to respond to an incident; <br /> mergency response and safety procedures for the mitigation, prevention, and abatement of a release or <br /> • eatened release to minimize harm or damage to persons,property,or the environment; <br /> se of the facility's emergency response equipment and supplies; <br /> Procedures for coordination with local emergency response organizations. <br /> The following employees have been trained as required by HSC 25507 a and 19 CCR §2651(a): <br /> GS ► a N Employee Name Training Date Trainer Name <br /> C G ls s P14e , J7—LOIL& e f 5 <br /> eA ka r1 <br /> /�Ab v,'s 7�i o 'Z_ - 10,t 6 4 <br /> S ei V C S 1 1Tr1/C1 l� L- 0QCUV 0 Z 'zb -L 1 � <br /> (7 CWL Jgr � Z - - X.,...��� ILL <br /> L„y 4«LI Uenf Coln rK <br /> Andrade 'L 6 -�e J >e, <br /> • (Continued on reverse) <br /> UN-103 www.unidocs.org 1/2-Rev.06/28/17 <br />