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0 0 <br /> UNDERGROUND STORAGE TANK SYSTEM <br /> DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br /> For use by Unfd cs Member Agencies or where approved by your Local Jurisdiction <br /> Authority Cited: Title 23,Div.3, Ch. 16 California Code of Regulations(CCR) <br /> Facility Name: 1—y ; T�cp ga d Q-"L•-�(.-- <br /> Facility Site Address: ! ,,,J City: G, <br /> Section 2715 of Title 23, California Code of Regulations, requires that Designated Underground Storage Tank Operators <br /> provide training to facility employees who have responsibilities associated with the operation and/or maintenance of <br /> underground storage tank(UST)systems. This training must be provided by July 1,2005,and every 12 months thereafter. <br /> For facility employees hired after July 1,2005, the initial training must be provided within 30 days of the date of hire. At <br /> least one of the facility employees present during operating hours must have current training.This training must include,but <br /> is not limited to,the following items as specified in 23 CCR Sections 27150(1)and(2): <br /> ❑ Operation of the UST system in a manner consistent with the facility's Best Management Practices; <br /> ❑ The employee's role with regard to UST monitoring equipment as specified in the written UST Monitoring Plan: <br /> ❑ The employee's role with regard to spills and overfills as specified in the written UST Response Plan; <br /> ❑ Name(s)of contact person(s)for emergencies and monitoring equipment alarms; <br /> ❑ For facilities that are not routinely staffed,facility employee responsibilities as specified in the training program <br /> approved by the local UST regulatory agency. <br /> 23 CCR§2715(f)(3)requires that a list of employees who have been trained by the Designated Underground Storage Tank <br /> Operator(s)be maintained on-site,or off-site at a readily-available location if approved by the local a eg ncv and provided to <br /> the local agency upon request.Completion of this form will satisfy UST training record loping requirements.The following <br /> employees have been trained as required by 23 CCR Sections 2715(f)(1)and(2): <br /> Facift Em to ee Name Training Date Hire Date 'ner Nam? <br /> fad [`Z- -!o 2�7 <br /> !2. i. �- <br /> (Continued on reverse) <br /> if hired after July 1,2005. <br /> 2 Trainer must be a current Designated UST Operator for the facility at the time of training. <br /> UN-061-1/2 www.aeidecs.ora 07/13/05 <br />