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07/02/2018 19:56 5107963470 SHARMA PAGE 02 k-jECE- D t ! UNDERGROUND STORAGE TANIK SYSTEM 18 DESIGNATED OPERATOR FACILITY EWLOVEE TRAINING CO FQr use by Unidoes Member Ageneeec nr u•ihery cr�,rt+v¢d byyoarr Laeal✓u+udiuiwr 4.urhorlty Ctred; Title 23, Dig, 3, Ch IG California Code ofReb rarions(CCR) ENVIRONMENTAL H�Ae Tu ncQARTMENT facility Name: (� Facility Site Address: �r1 l� 7v`��'l% City: Section 2715 of Title 23, California Code of Regulations, requires that Designated Underground Storage Tank Operators provide training to facility employees who have responsibilities associated with the operation and/or maintenance of underground storage tank (UST) systems- This training must be provided by July 1,2005, and every 12 months thereafter. for facility employees hired after July 1, 2005, the initial training must be provided within 30 days of the date of hire-At least one of the facility employees present during operating hours must have current training. This training must include, but is not limited to,the following items as specified in 23 CCR Soctiorts 2715(17(1)and(2); A Operation of the LIST system in a manner consistent with the facility's Best Management Practices; 20 The employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring Plan; The employee's role with regard to spills and overfills as specified in the written UST Response plan,- 'K Name(s)of contact person(s)for emergencies and monitoring equipmept alarms; For facilities that are not routinely staffed,facility employee responsibilities as specified in the training program approved by the local UST regulatory agency- 23 CCR§2715(f)(3)rcquiros that a list of employees who have been trained by the Designated Underground Storage Tank Operator(s)be maintained on-site_or off-site at s readily-available location ifapprctvod by-1he local agency;and provided to the local agency upon request. Completion of this form will satisfy UST training record keeping requirements. The following employees have been trained as required by 23 CCR Sections 2715(f)(1)and(2); Facility Em to ee Name Trainin Date Hire Dater Traluer Name' CA —I Ali kcl 1 lb--q- I� q �5_�--� ► y �, ll nn 11__ 1 b� b 6--f.--r? 1b iq � 15 -il �� 11 ct►�u 5�,�. ~CO (Condtrued on reverse) if hired after July 1,2oo5. 'Trainer must be a current Designated UST Operator for the I�Jiry aa,the time of trairi�g UN-061•1R �-4aaducs.o b ON73/OS Received Time Jul, 2. 2018 ' 9:45PM No, 3804