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CALIFORNIA ON-SITE STATION TRAINING FORM <br /> ANNUAL REFRESHER TRAINING VERIFICATION <br /> Site Number Dealer <br /> Street Address `� 3 r-j L p o l-A p o S I <br /> City,zip Code JT D ( k <br /> Employee Name(Print) V 4C <br /> I acknowledge that I have received and understand environmental compliance training in <br /> the following areas (please initial): <br /> Initial Date <br /> Hazardous Materials Management(Hazardous Materials Management/Business Plan) <br /> 1. Which materials at the station are hazardous <br /> 2. Where these materials are stored <br /> 3. How these materials are to be handled,stored,and disposed of <br /> 4. What Material Safety Data Sheets(MSDS)are and where they are kept at the station <br /> S.Training topics included in the HMMP, including review of MSDS and the emergency <br /> response plan <br /> Waste Management Procedures <br /> 1. Procedures in the service bay <br /> 2. The correct management for products in the station <br /> 3. Proper labeling of wastes <br /> 4. The importance of manifesting or having a receipt for all hazardous materials that leave the <br /> site <br /> Spill and Leak Response(Spill Response Plan) <br /> 1. Location of spill response equipment <br /> 2. Location of spill or leak contact list,reporting procedures <br /> 3. Location of emergency fuel shut-off switch <br /> Employee Signature Social Sec.Number Date <br /> Training verified by (-" a S <br /> Dealer/Instructor bati <br /> MAINTAIN THIS FORM THE ENTIRE TIME THE EMPLOYEE WORKS AT THE FACILITY <br /> 00859(REV.012000) <br />