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COMCNFAOT (2)
Environmental Health - Public
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2500 – Emergency Response Program
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COMCNFAOT (2)
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Last modified
2/8/2022 3:11:00 PM
Creation date
2/8/2022 3:05:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COMCNFAOT
PE
2546
FACILITY_NAME
CHEVRON STATION #210997
STREET_NUMBER
1442
STREET_NAME
COLONY
STREET_TYPE
DR
City
RIPON
Zip
95366
APN
26102028
ENTERED_DATE
12/12/2021 12:00:00 AM
SITE_LOCATION
1442 COLONY RD
RECEIVED_DATE
12/12/2021 12:00:00 AM
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
Scanner
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EHD - Public
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EMERGENCY RESPONSE/UST MONITORING ALARM IRA! Ni N <br />Training Checklist <br />,Employee Name <br /> FACILITY # <br />t•iAk,W 1\itk <br /> <br />,;-16q97; <br /> <br />Erner. ency RespOnse-TOols & Procedures <br />-Visually - pointed out and reviewed with the Trainee each of the following: <br />[a' Spill Response items (Hydrocarbon Response Bags, extra pads, absorbent, broom & dust pan. MoGas spill <br />wick): explained spVovertilis response. ciearrup and reporeng procedures. Refer to the 'Designated Operator Training Cutricuium' <br /> (initial) Hazardous Waste Barrels: walked Trainee to lac:alio,' and explained procedures relating to their use, i e purpose of <br />orent barrels and procedures when depositing items in ft:am <br />-(initial) Location of (all) Fire Extinguishers- (inside & outside): walked the Trainee to each one <br />(initial) Location of (all) Fire Alarm "Pull Stations"• if applicable: walked the Trainee to each one <br />(initial) Location of (all) Emergency Shutoff switches - (inside & outside): weifeed the Trainee to each one <br />(initial) Electrical Service Main Breaker -Water Main Valves - (if applicable- Natural Gas Shutoff & Sprinkler Controls & <br />/ RisI warkee the Trainee to each one and explained how to access & operate them <br />gr,(initial) Emergency Response Binder: reviewed 'air' the documents in the binder and the procedures when evacuating_ <br />4._(initial) Location of (all) CO2 (bulk or canisters). CO2 sensors, CO2 alarms with placard (backroom and c-store) - <br />wilked the Trainee to all CO2 equipment and explained procedures relating to their use, i.e. purpose for sensor light and the different <br />alarms_ Refer to *Designated Operate( training Curriculum' <br />Reviewed and explained all the procedures for the following: <br />- Steps to Shut-Down and Evacuate <br />(initial) First Aid Procedures for Exposure to Gasoline & Diesel <br />(initial) Small & Large Gasoline Diesel spill and a non-gasoline vehicle-fluid spill cleanup procedure (Spill Response <br />urea). <br />(initial) Site Specific Emergency Response & Training Plan <br />(initial) HMBP <br />UST Monitoring System & Alarm Reporting Procedures <br />Instructed the Trainee on the following: <br />MonitoringEgeipment <br />- (initial) Took Trainee to the TLM System. <br />-(Initial) Reviewed the site's specific type of TLM system (Veeder-Root, In-Conn, etc.) <br />-(Inide!) Discussed the equipment operating procedures (components & functions). <br />Alarm Reporting Procedures <br />1 1 -timbal) Reviewed the Visual & Audible alerts. <br />(initial) Demonstrated process for silencing the audible alarm. <br />e7 el (initial) Reviewed the (2) categones of alarms (UST& ISO). Discussed the Quick Reference Alarm Card and the means of <br />distinguishing a Vapor Alarm from an ISO Alarm. <br />L,7 ..N., (initial) Reviewed the reporting process for Air Quality Alarms. i.e record alarrn in ISO Binder (tab 1). record in <br />Maintenance Binder, and the timelines for reporting an Air Quality alarm to maintenance. <br />J ,r (initial) Reviewed the reporting process for UST Alarms, i.e. record alarm in the Maintenance Binder, and immediately <br />report alarm to maintenance_ <br />Trainee Signature - <br />..._, , <br />,- 4 r :,..4.4.--c•--(.1___ .—.--:, - Date: I d... - 10- p.I <br />Dosignated Operator Signature /itari gefireft4 8360137 ' Date: <br />File in employee station file only <br />Revised 5/23/20
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