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UNDERGROUND STORAGE TSYSTEM <br /> DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br /> For use by Unidocs 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: li�L Lc-r- -�1. 1+alt -J (D C-7 <br /> Facitity Site Address: t1"'S t OO City: La Q t <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 2715(t)(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 /> Operators)be maintained on-site,or off-site at a readily-available location if AgRMvAd by the local agency.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)(1)and(2): <br /> Faciii <br /> Employee Name TEgEiEg Date Him Date' Trainer N e2 <br /> G <br /> .�— &ee (Continued on reverse) <br /> 'If hired after July I,2065. �v <br /> 'Trainer su a be a a intro Dempatad UST Operator for the facility at the bare of umning <br /> UN-661-1/2 www.unidoes orb JUN 0 3 2016 07113M <br /> ,tf uta <br />