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Oct 23 OS 12:23p 019 209-16 -0142 P•7 <br />t_ <br />UNDERGROUND STORAGE TANK SYSTEM <br />DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br />For use by Undoes Member Agencies or where approved by your Local Jurisdiction <br />Authority Cited: Title 23, Div. 3, CIL 16California Code ofRegulations(CCR) <br />Facility Name: G isn.n%,r w a. -y Cl, ti V r0 n <br />Facility Site Address: 5a g ( G s. to Want City- S fe e k 7-0 ✓t <br />Section 2715 of Title 23, California Code of Regulations, requires that Designated Underground Storage Tank Operators <br />provide training to facility employees who have responsibilities associated with the operation and/or maintenance of <br />underground storage tank (UST) systems. This training must be provided by July 1, 2005, and every 12 months thereafter. For <br />facility employees hired after July 1, 2005, the initial training must be provided within 30 days of the date of hire. At least one <br />of the facility employees present during operating hours must have current training. This training must include, but is not <br />limited to, the following items as specified in 23 CCR Sections 2715(f)(1) and (2): <br />2r Operation of the UST system in a mariner consistent with the facility's Best Management Practices; <br />P1 The employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring Plan; <br />Pf The employee's role with regard to spills and overfills as specified in the written UST Response Plan; <br />2( Name(s) of contact person(s) for emergencies and monitoring equipment alarms; <br />For facilities that are not routinely staffed, facility employee responsibilities as specified in the training program <br />approved by the local UST regulatory agency. <br />23 CCR § 2715(f)(3) requires that a list of employees who have been trained by the Designated Underground Storage Tank <br />Operator(s) be maintained on-site, or off-site at a readily available location if approved by the local agency, and provided to <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 2715(f)(1) and (2): <br />Facility Employee Name <br />cII <br />y <br />11W3111111 <br />0 ft ' Mow, <br />LPW�NWVWVWxM <br />1 MIN <br />. M rM <br />.. <br />(/ 1011 <br />.. G..iur <br />If hired after July 1, 2005. <br />Trainer must be a current Designated UST Operator for the Facility at the time of training. <br />UN -061- VI <br />www.aeideewrg <br />07/13/05 <br />