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UNDERGROUND STORAGE TANK SYSTEM <br />DESIGNATED OPERATOR FACILITY EMPLOYEE TRAMMG RECO <br />For use by Unidocs Member Agencies or where approved by your Local Jurisdiction <br />AuthorO Cited I-ak 23, Div_ 3, Ch. 16 California Code of Regulagons (CCR) 7 <br />Facility Name:_i�_ <br />Facility Site Address: W - I l r� ,� R cL ` --- City: <br />Section 2715 of Title 23, California Code of Regulations, requires that Designated Underground Storage Tank Operators <br />provide tiering to facility employees who have responsibilities associated with the operation and/or maintenance of <br />underground storage tank (UST) systn3ns. This training must be provided by July 1, 2005, and every 12 months there after - <br />For facility employees hired after July 1, 2005, the initial training must be provided Within 30 days of the date of hive. At <br />least aIle of the facility employees present during operating hours must have current training. This trauiuug must include, but <br />is not limited to, the following items as specified in 23 CCR Sections 2715(f)(1) and (2): <br />JiV Operation of the UST system in a manner consistent with the facility's Best Management Practices; <br />H-' The employee's role with regard to UST monitoring equipment as specified in the Viten UST Monitoring Plan; <br />The entployee's role with regard to spills and overfills as specified in the written UST Response pian; <br />H' Name(s) of contact persons) for emergencies and monitoring equipment alarms; <br />23 CCR § 27150(3) requires that a list of employees who have beern trained by the Designated Underground Storage Tank <br />Operalor(s) be maiatairted on-site, or off-site at a readily -available location if approved by the loci age, Md pWVim <br />ded <br />the local agency upon request- Completion of this form will satisfy UST training record keeping requirements. The following <br />employees have been trained as required by 23 CCR Sections 271 5(f)(1) and (2): <br />Facility Employee Nairne <br />Training Date <br />)Tiire Date <br />Trainer Na e <br />YN r u <br />" - - ( <br />- <br />4 -1�1 <br />Lot d <br />l l -''► <br />- <br />- <br />�� <br />(Condmued on r erase, . EIVED <br />' if hired dta July 1. 2.005- MAR 3 U 2018 <br />'Trainer must be a awmt Designated UST Operator forthe faclity at the time oftraiaing. <br />•� ,, __�._---- ENVIRONMENTAL <br />Ml,7,uC <br />�» D-PARTMENT <br />