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011::I•nCll. OF:: FAlfll. Wllllrll. II1II.ALlfllll F1II,,,,Ab114114I1lNG ANII,6 II,AII VII.II t..all"I1�II,:Ih�tt <br />q�� F A44 II' �C IIII II Fllll :S Il kll :Vll .Il..f 1F11 gII :N If II`tll�All"'bll�'3IM <br />7 <br />TEST TECHNICIANS <br />Provide Following Information for Each Test Technician Employed by the Agency (Attach <br />additional sheets if needed <br />-To update expiration date a renewal application for OPAA <br />and proof of renewal <br />for certification/license shall be required <br />Test Technician's <br />Certification/ <br />Certification/ <br />Certification/ <br />Name <br />License Type <br />Licensing Agency <br />License Number <br />Expiration Date" <br />Comments <br />NICL'ILLVLL III <br />Soils <br />NICET <br />129413 <br />06-01-19 <br />NICEI'LevelIII <br />NiCF1' <br />129413 <br />06-01-19 <br />Asphalt <br />N I C I!'i Level l l i <br />NICET <br />129413 <br />o6-01-19 <br />Michael Magana <br />Concrete <br />CI Aggregate <br />CI <br />01112,901 <br />12-20-21_Updated <br />since DSA App <br />CT Field Testing <br />ACI <br />01112801 <br />03-17-17 <br />Tech <br />ACT Strength <br />ACI <br />01112801 <br />08-13-19 <br />Testing Tech <br />UpdaIed since DSA App <br />Caltrans- Soils <br />Caltrans <br />Na <br />1-31-19 <br />Updated Since DSA <br />Michael Magana <br />Caltrans - Concrete <br />Caltrans <br />Na <br />12-2-18 <br />PP <br />Caltrans - Asphalt <br />Caltrans <br />Na <br />J-17-17 <br />M3110Sanche7 <br />ACT Strcngth <br />ACI <br />0138403 <br />11/10/21 <br />Testing Tech <br />ACI Uield l'estin,v <br />CI <br />113 <br />S-12-17 <br />Eric Finley <br />i'ech <br />HMA SOILS PCC <br />Caltrans <br />Na <br />12-:31-17 <br />CT Field Testing <br />ACI <br />Na <br />12-11-18 <br />Tech <br />Edmond labbour <br />ACT SLrength TesL <br />Tech <br />ACI <br />Na <br />11-11-18 <br />IIMA / SOILS / PCC <br />Olt•ans <br />Na <br />1-31-19 <br />Curtis Bullis <br />Cl Field Testing <br />CI <br />Na <br />3-17-17 <br />Tcsh <br />CI Field Testing <br />Duminic Muntemayur <br />Tech <br />CI <br />Na <br />1-17-20 <br />Soils/PCC <br />Calwnls <br />Na <br />5-9-17 <br />ACT Field Testing <br />ACI <br />00988756 <br />9-16-18 <br />Tech <br />Thomas ltehosky <br />ICC Soils <br />ICC <br />208315r; <br />W-18-19 <br />Snits, Concrete <br />NTCFT <br />130S83 <br />10-1-2019 <br />Asphalt <br />]efh•ey Diaz <br />Soils, Concrete. <br />CdllranS <br />t18 <br />dr10115 <br />S h31t <br />Reinforced Cone, Mas, <br />ICC <br />5320836 <br />07-2018 <br />Fire roofin . Soils. <br />CI (Multi) <br />CI <br />01074782 <br />Various <br />Test Terhnirians with expired <br />license shall not be permitted to pertorm Tests <br />STATE OF CALIFt62N19=YiVN1 <br />OSFi-FtJ-r WAA- 19P (Lif2-W'OIeS) <br />_VZ V >017 <br />AND HUMAN SERVICES AGENCY <br />OPAA-0010 1 b' <br />