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011::I:1C11.OF:: SIfAlfll VWllllrll.II1II.AILlfllll II..1II,,,,Ab114114I1lNGAP+II II,AII VII.II t..all"I1�II,:Ih�tt <br />14 <br />SPECIAL INSPECTORS (Continued) <br />Provide Following Information for Each Special Inspector 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 />Inspector's Name <br />Certification/ <br />License Type <br />Certification/ <br />Licensing Agency <br />Certification/ <br />License Number <br />Expiration Date" <br />Comments <br />S eCiat InSjoeMrS with ex <br />ire(I license Shall not be <br />ennilted l0 errorro Special Ins echoos <br />I • p <br />S-FKrE OF CALIFt M9--YMN1 <br />OSFi-I-LD-r WAA- I00 (G/2-�{"'pi eS) <br />_VZ V >017 <br />AND HUMAN SERVICES AGENCY <br />0PAA r101 )-1b' <br />