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fill II null III SFAFII::Wllllrll. 11lll:AILlf1111Ifa1I....AININIING ANll..t I1..t11'VII.II )II"IMII INtt <br />'f/�d�hi�p� �y� rs •AG;:, __11 if _'.!,,:a .) 'V' Sa db1 _�. h.N"If .Y "afn'�al101N <br />14 <br />SPECIAL INSPECTORS <br />Provide Following Information for Each Special Inspector Employed by the Agency (Attach <br />additional sheots if needed <br />"To update expiration date a renewal application for OPAA <br />and proof of renewal <br />for certificationilicense shall be required <br />Certification/ <br />Certification/ <br />Certification/ <br />Inspector's Name <br />License Type <br />Licensing Agency <br />License Number <br />Expiration Date* <br />Comments <br />Spray Applied <br />ICC <br />1138578 <br />10/06/9091 <br />FT <br />Fireproofing <br />Structural Steel & <br />ICC <br />1138578 <br />10/06/2021 <br />FT <br />Welding <br />Structural Steel and <br />ICC <br />1138578 <br />10/06/2021 <br />FT <br />bolting <br />Prestressed Concrete <br />ICC <br />1138578 <br />10/06/2021 <br />FT <br />Reinforced Concrete <br />ICC <br />1138578 <br />10/06/2021 <br />FT <br />Robert Turchick <br />Structural Masonry <br />ICC <br />1138578 <br />10106190?1 <br />FT <br />Certified Welding <br />AWS <br />13011121 <br />01/31/2022 <br />FT <br />Inspector <br />Shotcrete <br />DSA <br />5675 <br />12/31/2019 <br />FT <br />Class 2 <br />DSA <br />3729 <br />03/17/2021 <br />FT <br />Masonry <br />DSA <br />5399 <br />02/23/2021 <br />FT <br />Soils <br />ICC <br />8164532 <br />10/08/2020 <br />FT <br />Spray Applied <br />Fireproofing <br />ICC <br />8164532 <br />06/16/2021 <br />FT <br />Reinforced Concrete <br />ICC <br />8164532 <br />08/20/2021 <br />FT <br />Carl De La Torre <br />Prestressed Concrete <br />ICC <br />8164532 <br />10/13/2021 <br />FT <br />Structural Masonry <br />ICC <br />8164532 <br />10/28/2021 <br />FT <br />Structural Steel and <br />ICC <br />8164532 <br />11/17/2021 <br />FT <br />bolting <br />FT <br />Spray Applied <br />ICC <br />5119934 <br />03/12/2021 <br />Fireproofing <br />Structural Welding <br />ICC <br />5119934 <br />02/09/2020 <br />FT <br />Chris Shipp <br />Structural Steel and <br />ICC <br />5119934 <br />02/09/2020 <br />FT <br />bolting <br />Certified Welding <br />AWS <br />02040121 <br />04/30/2020 <br />FT <br />Inspector <br />Special Inspectors with expired <br />license shall not be penritted to perform Special Inspections <br />STArE OF CALIFMM)! -WEAL <br />OSH-Ft]-OF'PJ';190 (q3/Ol!?nl �) <br />d!3C?OI4 <br />AND HUMAN SERVICES AGENCY <br />OPAA-+004 '1 (� <br />r I �IJt I� I afy9 <br />