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UNDERGR0I7ND STORAGE ®A6E• GE 119.1.E K SYSTEM <br />M <br />DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br />For use by Unidocs Member fancies or where approved by your Local Jurisdiction <br />Authority Cited: Title 23, Div. 3, Ch. 16 California Code of Regulations (CCR) <br />Facility Name: _ ACO <br />Facility Site Address: �8� �/. GTo r �'e� city: : <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 Jury 1, 2005, and every 12 months thereafter. <br />For facility employees hired after July 1, 2405, the initial training must he provided within 30 days of the date of hire. At <br />least one of the facility employees present during operating hoursmust have current hsinitlg. This training must include, but <br />is not limited to, the following items as specified in 23 CCR Sections 2715(1)(1) and (2): <br />❑ Operation of the UST system in a manner consistent with thefacility'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 />Operators) be maintained on-site, or off-site at a readily -available loc*ation if at>trrmed by the local agenclr, and provided to <br />the local agency upon request. Completion of this form will satisfy UST training record keeping requirements. The following <br />employees have been trained as required by 23 CCR Sections 2715(f {l) and (2): <br />Fa 'li Em ioy� IName <br />'t !� <br />Tra'ft Wtte <br />+� r� •� 6 <br />Hire Date' <br />Trainer Names <br />iY�F^' _.�� � Com"+ <br />ri A r, ck de Z <br />10-;o V <br />®-ao-17 <br />(Con inued on reverse) <br />° Tf hued after July 1, 2005. <br />2 Traver wast be a curvet Designated UST Operator fur the Focality at the tune of training. <br />l— UN -061-1/2 www.nnkioes o T 471}3/05 <br />