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OPERATORS Of SOUTHERN C_AL1F0RN1AtIllllllllll _ O Facility: Pilot Flying J - # 1017 /� 345 Roth Rd, Lathrop, CA 95330 "Facility Employee" UST Compliance Training Sign-In Sheet The people listed in the UST Compliance Training Sign-In Sheet below are UST training. Training may be conducted in conjunction with monthly DO employees at the indicated facility whose job responsibilities require them to inspections, given advance notice. respond to underground storage tank (UST) monitoring system alarms, spills or The UST Operators Designated Operator indicated at the bottom of this form UST overfills. As such, they qualify as"facility employees"or FEs per CCR Title has trained the listed FEs on the training date above in the following topics at a 23, Chapter 16, Section 2711. minimum: Some FEs are also facility owners/operators or facility managers reporting to R Facility best management practices(use of system tests, documented the facility owner/operator. The column entitled O/O or Mgr(Owner/Operator responses, etc.) or Manager) indicates which listed FE is also an owner/operator or facility manager at the noted facility. ■ The FE's role in monitoring system alarm responses as noted in the Each identified FE must be annually trained in the environmental aspects of the facility's Monitoring Plan. proper operation and maintenance of the UST system at the facility. New hire E The FE's role in spill and overfill responses as noted in the facility's FEs must be trained within 30 days of their hire date; otherwise they cannot be Monitoring Plan. left in charge of facility UST operations until they have received their annual Review of emergency contact procedures. Please print le ibl EmployeeD. . . Title EinployeeEmployee IS Le a-A A ? 3 ( 1-0 hb�Q it&�&) 46n t?n &,s T �9 ( 5qlol eta GS S L - tvs Ra -j ; v ReItCon r .. ,e rice Sob Uki r 'If known Lance York 5296385-UC / August 1 , 2022 Facility DO Name Si ture of ,co rmation of FE Training International Code Council(ICC)Certification#and Expiration Date