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HAZARDOUS MATERIALS BUSINESS PLAN <br />FACILITY EMPLOYEE TRAINING RECORD <br />For use by Unidocs Member Agencies or where approved by your Local Jurisdiction <br />AuthorityCited: California Health and Safety Code Chapter 6.95 (HSC); Title 19 California Code of Regulations (CCR) <br />Facility Name: <br />Site Address: <br />City: <br />California Health and Safety Code §25507(a) and Title 19 California Code of Regulations §2651(a) require that a <br />Hazardous Materials Business Plan (HMBP) facility implement its HMBP, including the training plan specified in <br />HSC §25505(a)(4) and 19 CCR §2659(a)(4). Taking into account the position of each employee, training for new <br />employees must be provided in safety procedures in the event of a release or threatened release of a hazardous <br />material. Annual refresher training is required. This training must be documented electronically or by hard copy <br />records. Training records for the past three years must be kept available for inspection. <br />HMBP training must include, but is not limited to, the following: <br />❑X Methods for safe handling of hazardous materials; <br />❑X Identification of areas of the facility and mechanical or other systems that require immediate inspection or <br />isolation because of their vulnerability to earthquake related ground motion; <br />❑X Evacuation plans and procedures, including immediate notification, for the facility; <br />❑X Identification of local emergency medical assistance appropriate for potential accident scenarios; <br />❑X Notification of local emergency response personnel, the Unified Program Agency, the California Emergency <br />Management Agency, and persons within the facility who are necessary to respond to an incident; <br />❑X Emergency response and safety procedures for the mitigation, prevention, and abatement of a release or <br />threatened release to minimize harm or damage to persons, property, or the environment; <br />❑X Use of the facility's emergency response equipment and supplies; <br />❑X Procedures for coordination with local emergency response organizations. <br />The following employees have been trained as required by HSC §25507(a) and 19 CCR §2651(a): <br />Employee Name Training Date Trainer Name <br />(Continued on reverse) <br />UN -103 www.unidocs.org 1/2 - Rev. 06/28/17 <br />