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COMPLIANCE INFO PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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JACK TONE
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2200 - Hazardous Waste Program
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PR0516231
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COMPLIANCE INFO PRE 2019
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Last modified
11/22/2024 2:31:47 PM
Creation date
1/3/2019 2:19:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0516231
PE
2220
FACILITY_ID
FA0006672
FACILITY_NAME
FLYING J TRAVEL PLAZA #618*
STREET_NUMBER
1501
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
22811017
CURRENT_STATUS
01
SITE_LOCATION
1501 N JACK TONE RD
P_LOCATION
05
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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06/25/2012 00:35 #0379 P. 007/007 <br /> UST Facility ID <br /> Ren.atmrroos <br /> O ERATORS PFJ-618 <br /> I <br /> Training A knowledgement Form <br /> "Facil"iN Em o ee" Hazardous Materials Tr°ainin <br /> —TO 0—� Pilot/Flying"Jn#618 <br /> 1501 Jack Tone Rd., Ri , CA 95366 llc,,- � 6 <br /> I <br /> FE htitials if <br /> Compfra—E)p-Mons mo has Reviewed with FE <br /> 1, The FE Can locate and describe tank and piping systems as veli as monitoring equipment.The FE can explain the Daily <br /> Monitoring System Check and Alarm/Response requiremen i and is cornpeterrt in completing these fomes. <br /> 2.The FE can define which materials at the facility are hazardo�.s and what makes them hazardous.The FE can describe <br /> J h where and how th-e materials are stored. <br /> 3_The FE can describe taw these materials are to be handled, ored anti d �y <br /> issues regarding the Storage �P�d lat The eg can ewe,5 the compatibility <br /> Drage ct hazardous waste.The FE describe basic regulations regarding the starage of <br /> �! Hazardous Wastes. <br /> • 4. The FE can describe the purpose and can complete and install the Hazardous Waste Label.The FE can explain the <br /> Jam" regulations regarding the`Start Date'and accumutabon time period5 of hazardous waste-The FE can demonstrate <br /> competence in Completing the Hazardous Waste Inspection Checklist <br /> 5. The FE can describe the purpose of the Material Safety Data heets(MSDS)and where this information is available.The <br /> FE Can describe basic information available in the MSDS and their purpose in the event of emergency. <br /> A 6.The FE can expiam the purpose Of the fadtity's Release Resp Dnse Plan and can demonstrate knowledge about spiillleak <br /> YC response('worst case discharge"and-most likely discharged including completing the fauTdy's SO4 Log <br /> _ - <br /> The FE can d�erentuAe between`Recordable'spills and` <br /> A �FE can th Spits and Spand can describe the requirernenis of each,N� competence in carrrplefing entries or to the Spic fig. <br /> .The FE can locate and competence in the use of the sites'Spill Response Kiri.The FE can describe types of <br /> materials needed for a spill kit as well as Personal Protective Equipment(PPS required. <br /> -The FE can indicate the kxation of emergency shut off switches and explain when they should be used.The FE can <br /> indicate the location of the fad7ibes Fire Extinguishers and demonstrate competence in their use.The FE can verbalize <br /> actions to be made in the event of an emergency,re_evacuation of persons to a safe Location. <br /> 1The FE can explain have Ione tank systerrt-mWed testing reoo" <br /> - and other documents should be kept by the fadlity <br /> (minimum three years in the binder or records repository,five}ears on Site.for the lifeline of the tanks offsite). <br /> I <br /> Fadfity Lmp4 Dye@ Ackraw{edge.r►ent: <br /> The Designat Operator for my fac&y, i kanti ied below, has reviewed with ine the expectations noted above Concerning My roles and <br /> responsibilitia in keeping my facility's underground Storage tank(UST)systeM in compliance with Caftfomia's UST <br /> an local regulations as well as <br /> Y req eats of the Certified Unified Program Agency(COPA)enforrii g these regulations at my facility. <br /> I understand tnd accept the duties and responsibilities that I am expected t perform with regard to my facility s Monitoring plan and <br /> Release Res se Plan. These include implementation of fadlity best management practices, response to monitoring system alarrns, <br /> response to S Als at the fueling islands or overfils at the tank pad, contacti identified emergency contacts in the event of a spill or <br /> release of p uct and the proper documentation of these activifies- <br /> I have asked oy questions I may have had conceming these e)pectations u 'I I was Satisfied I understood them.I understand that I am <br /> responsible in or in part for maintaining the required UST compliance de.Cuments for my station.I will ensure that these records will <br /> be kept in rdance with instructions provided to me by the CUPA having ju Fdkbon oveir my station. <br /> L } ETY-p <br /> -g1;2_7/);j <br /> KY LmPlOYea Name(please Print) FF Signa>vre and Date <br /> Trainee ter. � <br /> Face rty DO Name ignature, International Code Council(ICC)GertifiCatrO' n <br /> confirmation of FE refresherbaining and Expiration Date <br /> i <br />
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