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CALIFORNIA ON-SITE STATIC RAINING FORM - NEW EMPLOS TRAINING VERIFICATION <br /> Site Number Dealer <br /> Street Address__ _ 3 /V, FI 6_�D ZZi6 e 9' _. <br /> City, Zip Code �Clk+O 7 <br /> Employee Name(Print) <br /> I acknowledge that I have received and understand environmental compliance training in <br /> the following areas (please initial): <br /> UST System Operations Initial Date <br /> 1. The types and locations of the tanks at the station <br /> 2. The type and operation of the leak detection system <br /> 3. For electronic monitors, daily monitoring check log and alarm log Z �� <br /> Hazardous Materials Management (Hazardous Materials Management/Business Plan) <br /> I. 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 2 2- <br /> 4. What Material Safety Data Sheets (MSDS)are and where they are kept at the stationz 3 <br /> 5. Training topics included in the HMMP, including review of MSDSs and the emergency LM �Z Z <br /> response plan �U 2 Z3 <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 wastesVY\ <br /> 4. The importance of manifesting or having a receipt for all hazardous materials that leave the Z S- 13 <br /> site V1,.� <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 S Z3 <br /> 3. Location of emergency fuel shut-off switch S 2-3 <br /> Inventory Reconciliation �' Z <br /> 1. How to perform accurate inventory control _ <br /> 2. Follow-up of gasoline inventory overage/shortage (variance) Z <br /> 3. Reporting and maintaining inventory records <br /> Daily Self Inspection* S 2-3. <br /> 1. Type and operation of vapor recovery equipment at the facility Z <br /> 2. How toerform daily "N 2 <br /> p y inspection of equipment <br /> 3. Procedures for non-compliance equipment(tag out of order), complete maintenance log <br /> vyl <br /> Record Keeping (Maintenance, monitor, testing, wastes, inspections, inventory, permits, t aining, et ) <br /> 1. Location where records are kept <br /> 2. Types of records maintained at the facility/ length of time each record should be kept ^Z 23 <br /> Employee Signature Social Sec. Number bate <br /> Training verified by �( ,� P 0, j,7 Syg_�X� 3K*C <br /> Dealer/Instructor Date <br /> * For facilities within the jurisdiction of the South Coast Air Quality Management District, the training provided to <br /> employees must be certified by the agency. <br /> MAINTAIN THIS FORM THE ENTIRE TIME THE EMPLOYEE WORKS AT THE FACILITY <br /> 00957(REV 01/2000) <br />