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i <br /> ROiTkI `5TOkAGE TANK SYSTEM <br /> CILITY EMPLOYEE TRAINING RECORD <br /> DESIGNATE TOR FA <br /> For Member Agenuias orwhere approved by your Local Juriscaclion Q C 2 ; L 015 <br /> Rath Title 23, Div, 3, Ch- 16 California Code of Regularrom(CCR) <br /> „ C ENVIRONMENTAL <br /> Facility Name: til; n L Cn .y <br /> WCA,1T4 nCDe RT�ACMT <br /> Facility Site Address: I - <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 /> Willy 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 271 5(f)(1)and(2)= <br /> ❑ Operation of the USi'system in a manner consistent with the facility's Best Management Practices; <br /> ❑ The employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring Plan; <br /> ❑ The employee's role with regard to spills and overfills as specified in the written UST Response Pian; <br /> Cl Name(s)of contact person(s)for emergencies and monitoring equipment alarms; <br /> p 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 agnEy,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 /> Foci Em to ee Name Trriuift Date Hire Date Trainer Na e <br /> ���� <br /> (Cundnned on reverse) <br /> 'If himd titer July 1,2005. <br /> "rrniaar mutt be a cur l Dftwaod r1.5f Dpmauv fix the fmit"y u the lima n!0amin®. <br /> I1N•861•t!2 w"muldw"rit 97113i0a <br />