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M A(D jZ3 0 <br /> M <br /> � n <br /> N O O 0 <br /> 0 <br /> 0 EQ <br /> (D <br /> CO C, <br /> M <br /> In <br /> 0 <br /> 0 P <br /> 0 <br /> > <br /> 2. <br /> V—:7.F) Site Addr,,,i i M-—----- <br /> Title 23, callfcw'o.) k <br /> f"WJ <br /> !.I <br /> P�... �IX I infillitcnlulcc <br /> r�sp"'14'0; " u <br /> 11,,�_ery I-).months thereafter For <br /> CiNlY employees hired after July 1.2009,the initial hamingonisibc to �:j :ay_)ftbe thoe of hire.At least one <br /> D. <br /> Df the facility employees present duringcipemiinla hours must have vtirrrli lii his training must include. hot is not (D <br /> )limited to,the folinvang i1cians as specified in 23 CCR Sec tiou.,271 s(f,,f i') <br /> � Operation of the UST system in a manner consistent wijh Ih,fiillidy"s B-ze pn"le"w's, <br /> 11i The emPlo)cc's role,kith regard to LIST monitoring equipment as sOCclilco in the ouster UST I <br /> Mololonw,I lan. <br /> The emp'loyes c role with regard t to spills and overfills as specified in:he wine,us I Response Plan; <br /> 0 <br /> -R Name(s)of contact person(s)for cmereencies ard monitoring eqnipmem,aiannn: <br /> �' For facilities that we not routine!,staffed.facility employee rcspmlsibddis as pecificd in the training program CD <br /> approved by the local UST regulatory agency. 3 <br /> 23 CCR§2715(f)(3)requires that a list of employees who have been rained by(he Designated Underground Storage Tank — <br /> I bN the local—a"ClIeN.and provided to 0 <br /> ,Operator(s)be maintained on-site-or off-site at a readily-available location Daplinrovq! CD <br /> the local agency upon request Completion of this form will satisfy UST'training record keeping requirements.The following CD <br /> employees have been trained as required by 2"CCR Sections 2715(f)(J)and(2): 0 <br /> 117 <br /> Facitity Employee Name Trainun Date Hire IDn1 Trainer Name 7-- <br /> -70 <br /> ----------- <br /> (D <br /> 0 <br /> 0 <br /> M <br /> W <br /> (rowinved an reverse) 0 <br /> 0 00 <br /> 0 <br />