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CALIFORNIA ON-SITE STATION TRAINING FORM - NEW EMPLO E TRAINING VERIFICATION <br /> Site Number 5K 4'9 Dealer <br /> Street Address 3 2-02- uJ es i 14am rym -- <br /> City,Zip Codc S 4 c,'-k 10 rl I CA. <br /> --1 o <br /> Employee Name{Print} —Gin i r o— i oJJ <br /> I acknowledge that I have received and understand environmental compliance training in <br /> the following areas lease initial <br /> Initial Date <br /> UST System Operations <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 to / 2 5 <br /> Hazardous Materials Management(Hazardous Materials Management/Business Plan <br /> 1. Which materials at the station are hazardous i 2S <br /> 2. Where these materials are stored j Z5 <br /> 3. How these materials are to be handled,stored,and disposed of ZS <br /> 4.What Material Safety Data Sheets MSDS are and where they are kept at the station ! 2S <br /> 5.Training topics included in the HMMP,including review of MSDSs 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 f 5 <br /> 3. Proper labeling of wastes < ZS <br /> 4. The importance of manifesting or having a receipt for all hazardous materials that leave the Tr <br /> �,! <br /> site %46 <br /> Spill and Leak Response(Spill Response Plan <br /> 1. Location ofspill response equipment ! ZS <br /> 2. Location ofspill or leak contact list,reportinR procedures / ZS <br /> 3. Location of eme!gency emergencyfuel shut-off switch / ZS <br /> Inventory Reconciliation <br /> 1. How to arforin accurate inventory control ( ZS <br /> 2. Follow-up of gasoline inventoa overage/shortage variance / Z S <br /> 3. Reporting and maintaining inventory records / ZS <br /> Da!!y Self Inspection* 1 �5 <br /> 1. Type and operation of vapor recovery equipment at the facility ! <br /> 2. How to perform daily inspection of equipment i Z-S <br /> 3. Procedures for non-compliance equipment to out of order),complete maintenance to <br /> Record Keeping Maintenance monitor,testing2 wastes inspections,inventog,permits,trainin ,etc. <br /> 1. Location where records are kept <br /> 2. Types of records maintained at the facili /length of time each record should be kept e L S <br /> sEa �,e.�`�®tam► SOS Com' <br /> Employee Signature Social Sec.Number Da e <br /> Training verified by !Dc,---+4-� Acrr .►� (/2A-16 T - <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 00957 <br /> e <br />