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4 <br />/ OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT <br />M FACILITIES DEVELOPMENT DIVISION <br />14 <br />Provide Following Informa <br />additional sheets if needed) <br />*To update expiration date a <br />Inspector's Name Certification/ <br />License Type <br />Fireproofing <br />Jeffrey Diaz Reinforced Concrete <br />Kim Byrd <br />Troy Degener <br />Eric Kennedy <br />Robert Carman <br />Concrete <br />I Concrete <br />Concrete <br />Concrete <br />I Concrete <br />I Concrete <br />Concrete <br />Dennis Brown Prestressed Concrete <br />elding <br />Reinforced Concrete <br />Jesse Maddox elding <br />Reinforced Concrete <br />Masonry <br />Reinforced Concrete <br />Vartan Deirdeirtan <br />Prestressed Concrete <br />not <br />SPECIAL INSPECTORS <br />n for Each Special Inspector Em <br />ewal application for OPAA and proof of renews <br />Certification) Certification/ <br />jUcensing Agency License Number <br />5320836 <br />53201836 <br />5320836 <br />5320836 <br />1106095 <br />1106095 <br />1106095 <br />1109095 <br />5114248 <br />5114248 <br />5114248 <br />S114248 <br />5114248 <br />5077705 <br />5077705 <br />507770S <br />5077705 <br />507770S <br />5006860 <br />5006860 <br />5006860 <br />S006860 <br />5006860 <br />1066095 <br />1066095 <br />106609S <br />1066095 <br />5223743 <br />S223743 1 <br />5223743 1 <br />1026139 E <br />1026139 <br />1026139 5 <br />'ity P009633 n <br />Access to Safe, nuallly n.Iftare Environments that Meet Galifornla's Diverse and Dynamic Needs <br />led by the Agency (Attach <br />certification/license shall be required <br />Expiration Date* Comments <br />i-2018 Correct Exp Date <br />i-2018 Correct Exp Date <br />i-2018 Correct Exp Date <br />i_2018 Correct Exp Date <br />13-2017 <br />13-2017 <br />13-2017 <br />-20-2019 <br />7 <br />7 <br />7 <br />-2-2020 <br />-24-2019 <br />-24-2019 <br />14-2019 <br />14-2019 <br />14-2019 <br />ICC ID <br />ICC ID <br />ICC ID <br />ICC ID <br />ICC ID <br />OSHPD <br />STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY 1 <br />OSH-FD-OPAA-100 (6/24/2016) <br />3/28/2017 OPAA-0010-16 <br />Page 15 of 19 <br />