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�s r S s <br /> Large Quantity Generator Hazardous Wast raining Record 1,2 <br /> Facility Name: Instructor Name: <br /> C.c1*%Como A al ok L r.s So�,l� �Lnsav� <br /> Facility Address: c1 Instructor Qualifications': <br /> �10� �• rG� 1�ot`Gf�d �T e S�'���1 S-',c- U-11er AllaCU4 <br /> Type(s)of Training:' _Classroom Lecture —Computer-Based _On-the-job <br /> Employee Name: Job Title:5 <br /> Job Description:' <br /> Facility personnel hazardous waste management and emergency response training, relevant to their job,within <br /> 180 days of hire and refreshed annually(Title 22 California Code of Regulations(T22CCR)§66265.16(b and c))' <br /> Required topics(check off covered topics) <br /> 0 Hazardous waste contingency plan review and implementation,T22CCR§66265.16(a)(2) <br /> 0 Identification and segregation of incompatible hazardous waste or product,T22CCR§66265.16(a)(2) <br /> 0 Prevention, mitigation,abatement and notification procedures,emergency equipment,and emergency systems,T22CCR§ <br /> 66265.16(a)(3) <br /> Other topics,as applicable(check off covered topics) <br /> ® Procedures for using, inspecting, repairing and replacing facility emergency and monitoring equipment,T22CCR§ <br /> 66265.16(a)(3)(A) I <br /> ® Key parameters for automatic waste feed cut-off systems,T22CCR§66265.16(a)(3)(13) <br /> 0 Communications or alarm systems,T22CCR§66265.16(a)(3)(C) <br /> 0 Response to fires or explosions,T22CCR§66265.16(a)(3)(D) <br /> 0 Response to groundwater contamination incidents,T22CCR§66265.16(a)(3)(E) <br /> ! Shutdown of operations,T22CCR§66265.16(a)(3)(F) <br /> 0 Self-protection measures,T22CCR§66265.16(a)(3)(G) <br /> ! 0 Accident prevention methods,T22CCR§66265.16(a)(3)(H) <br /> ! 0 <br /> General awareness training required for all!personnel, required every 24 months (T22CCR§66265.16(a)(4)(A)) <br /> jCheck off covered topics <br /> 0 Description of the facility <br /> 0 Overview of the facility operations subject to hazardous waste control law and regulation <br /> j 0 Security and safety considerations related to hazardous waste <br /> 0 <br /> Function-specific job training for all personnel involved with hazardous waste management activities, required <br /> every 24 months (T22CCR§66265.16(a)(4)(B)) <br /> Check off covered topics <br /> 0 Overview of hazardous waste control law and regulation and site-specific procedures applicable to employee job tasks and <br /> functions. <br /> 0 <br /> Training for personnel engaged in hazardous waste shipping, required triennially (T22CCR§66265.16(a)) <br /> Check off covered topics <br /> 0 Training commensurate with their responsibilities to meet the requirements of Title 49 Code of Federal Regulations§ <br /> 172.704. <br /> 0 <br /> Signat a of employee (or certified):' Date of Training: <br /> �LAk Z , 2-0 ZU <br /> Page 1 of 2 version:Sept 22,2020 <br />