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CALIFORNIA ON-SITE STATION TRAINING FORM <br /> ANNUAL REFRESHER TRAINING VERIFICATION <br /> Site Number Dealer OAJ Q CB � t'L5 <br /> Street Address- <br /> City,Zip Code <br /> Employee Name(Print) r ` e <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 PI n) <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 Safe Data Sheets MSDS are and where they are ke t at the station <br /> 5. 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 ba <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 rocedures <br /> 3. Location of emergency fuel shut-off switch <br /> Employ ignature Social Sec.Number Date <br /> Training verified by ✓`"�''1 ! %1 <br /> Dealer/Instructor Date <br /> MAINTAIN THIS FORM THE ENTIRE TIME THE EMPLOYEE WORKS AT THE FACILITY 00959 <br />