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'his license has workers compensation it,,-wance with the <br /> STATE COMPENSATION {NSURA- FUND <br /> Policy Number: 1810506 Effective Date: 04/15/2005 Expire Date: 04/0112007 <br /> Workers Compensation History <br /> * * * laneous Information <br /> Vmt Vml <br /> Reran°rte Recole"dc <br /> fie..pewde�*^^or NmderaM�nr <br /> c°rl`W°y Co. c°rl`Way�� Natc.cn- <br /> HMc-H`�e��M� 11M('_Hende^^a, <br /> i6 pdw`.ert'fied i.en«ceAlf ed <br /> rylr.N°.wo 0,reP{a 1ee- Mr.is rw 0H W. <br /> cnxb'°'rr+'Miw+"`J�1 rwn&.r�µ��•d�l <br /> a Request <br /> rf")RED JACKET Certified Certified <br /> Technician VEEDER-ROOT Technician <br /> The tearer of this pad has �Y <br /> corse incorrylEted att>e mayacbjer bearer of ft card has%=e;sf* <br /> can martiaccam <br /> trarwig <br /> Carl Wayne Henderson ootase in the listed pro ticks). <br /> Technician#A25001 Carl Wayne Henderson <br /> Technician*A25001 <br /> Mechanical Line Leak Detectors <br /> Expires 7/5/2008 UST Monitoring systems-Level 1 <br /> You rntsAaTanrer:ad fv (Installation) <br /> h =Tcorn <br /> to confirm Expires e/11/2007 <br /> rBCp�f tfljg <br /> You mist contact Te hf"T-ning@gft=corn to corl(rm <br /> the Wrrerd certification record for this person <br /> O VEEDER-ROOT <br /> Name car,"Wayne" Henderson <br /> SignatureL�s <br /> certification! 006-05-2288 <br /> certification Level- 4 <br /> Expiration Date 2/1/2007 <br /> `See Reverse Side for Explanation of Levels <br />