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2575 Country Club Blvd, Stockton, CA. 95204 <br />10/24/2017 <br />PHOTO # 1 <br />ng and emergency procedure is not current <br />UNDERGROUND STORA(;H <br />DESIGNATED OPERATOR FACILITY I?INl'� fNk tiytir•N;M <br />wrr: <br />F•nrua•h,rl4ridrn:c,dlrml+,•r:f1�rrrrlra'nrudn'rr•n/,/rrnrr,/Imp„ur/1,12/AlrNrrN(r; rjF: <br />.4ulJrnrnrr'rtcd Tidr _J, Urr. i. r'h. lr, r'u/i/rrniiu r'nrlr „' (,I <br />l kal,'ulwir,u,, n'r'Ir/ . <br />ility Site Address: Z S 7S C car,✓ y G c .�ks (ity, - <br />on 2 a - of Title 23. California Code of Reghave <br />reigns, requiros associated with thederyrrund St°rte', Tan <br />de ;7715 <br />at <br />Lining to fnciliry, employees who have res onsihilities <br />rgtiund storage tank (UST) systems. This training mast be provided bro y July 1, 2(X)5, and every and/or mai <br />ry employees hired yesft resent during5, the initial operating hours training <br />imm have current id d within 30 days of heldate f hire <br />facility employees P training. This trainin <br />A to. the following items as specified in 23 CCR Sections 2715(fx 1) and (2)c b mavt includ <br />3 Operation of the UST system in a manner consistent with the facility's Best Management Pra(ices; <br />3 The employee's role with regard to UST monitoring equipment as specified in the written UST Monitori. <br />3 'rbc employee's role with regard to spills and overfills as specified in thewritten UST Response plan; <br />3 Name(s) of contact person(s) for emergencies and monitoring equipment alarms, <br />3 facility employee responsibilities as specified in the training f <br />approved by the local UST regulatory agency. <br />'R § 2715(fx3) requires that a list of employees who have been trained by the Designated Underground Ste <br />tor(s) be maintained on-site, or off-site at a readily -available location if aooroved by the total <br />AM- , and <br />:al agency upon request. Completion of this form will satisfy UST staining record keeping requirements. T1 <br />gees have been trained as required by 23 CCR Sections 2715(f)(1) and (2); <br />ty Em to ee Name Training Date <br />hire Date' <br />Trainer Name2 <br />-2A L• ►--t A --Z-& A f -2 `f - I i <br />l t <br />9-2,y-1 H <br />�( <br />le. K-,4) v f/— n—1 `i. <br />i t-17-1 L{ <br />k. L <br />(,'jV42�+- i <br />-Afv 'T2 T INCH Z'Z6 (6 <br />99i <br />ZAL z(lF� r Z -2.6-f6 <br />2- 24. -(f. <br />L���( 11 f <br />1 k t r <br />Ey'U <br />on reverse) <br />”/'y I, zoos. <br />n be a cunent fhsifinueA UST <br />Operator for the facility at the time of training. <br />Record ID PR0514045 <br />Betty Ho, EHS Page 1 of 2 <br />