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CALIFORNIA ON-SITE STATION TRAINING FORM <br /> ANNUAL REFRESHER TRAINING VERIFICATION ! <br /> Site Number <br /> _ ,5L/ -( g Dealer C-0 +j d C U !' i `Li to r <br /> Street Address 3024 x W- ,%xeo2-, os,n 2 <br /> City,Zip Code 4-0 c k 4wy . CA <br /> Employee Name(Print) Ta �yA_F—.,dCrt <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 Mann ementBusiness Plan <br /> 1. Which materials at the station are hazardous L_ -2 <br /> 2. Where these materials are stored -Z..- <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 r <br /> 5.Training topics included in the HMMP, including review of MSDS and the emergency <br /> respqnse plan <br /> Waste Management Procedures <br /> 1. Procedures in the service ba <br /> 2. The correct mane ement for products in the station <br /> 3. Proper labeling of wastes -2� <br /> 4. The importance of manifesting or having a receipt for all hazardous materials that leave the <br /> site <br /> Spill and Leak Response LSIpUl Response Plan <br /> 1. Location of spill response equipment <br /> 2. Location of spill or leak contact list,reporting rocedures -0- <br /> 3. Location of emergency fuel shut-off switch <br /> J <br /> Employee Signa '^ Social Sec.Number Date / <br /> raining verified by c'•..�..� g �" "' v .°e� <br /> Dealer/Instructor Date <br /> MAINTAIN THIS FORM THE ENTIRE TIME THE EMPLOYEE WORKS AT THE FACILITY 00959 <br /> e <br />