.��..
<br /> Ir II IJ
<br /> II Ii
<br /> . III ,; III I'I
<br /> I
<br /> � y�+y�'
<br /> 1 p:IY II fII 'II III�IIIII,I,.I� III .I;I I.I_ 111' I III I, � I IIII [�1JII IR V' :L�-+711Osw'SLiE",I�yrI'tif'�K
<br /> - ' HIM
<br /> 1d4 INN ' ` R; rII ` '�F1a7E 4P+ae irr 1r R�II+TICi'h��` ri I I'yy, yry �1 �i��
<br /> IF F I l l III II '1 I,�.IA rfY Y1Vr� ..iti.rr��..r.-��•�-�.�.:
<br /> ���� u n csxI GEZ$i'7
<br /> S'• PII - yy,,,,. I'rM.�l _� � I ..J$-.�� -�uj f 1./ f
<br /> AGN$,�.�+JA,iddr"*A ,III 111 I. 1'� .».n.AI _. 1 .... •�•[ _., �..•. ,...rte'.—�:.�._ -^
<br /> III 1� E`' Y gyp'�i'i.M 1.
<br /> [■7' �'�I7�Ji -
<br /> 1 1 aoil �' ov 44..r�,�,,,.,�_.r E.']"�4lkIF OPERATOR I�IIF�+R(4'[A' La4�' - I.
<br /> iat �"NO STURA
<br /> I'terrtd a'1[Z+egif ra , �� a-r----�,:11,r�-a.�.
<br /> II Tr�tlrlln7{�C �rfffritovl]
<br /> � �+P4rProrvtidirr�r �
<br /> ' I p I 'IK;�`u C�r57Yt.,+llibn I��'pllali�rY lya'la f
<br /> -
<br /> r.m _ Fr�ACILI'XY EMIPLOYEE INFORMATION ,.._ �
<br /> �' II I,'I n �• r .RI�a .r�.,rn+ter'.r�.w�.i:1.:.r„ �.r��rt�� I
<br /> the[A6111Ly em,phoyef wtoteoctobw 11,2019 rrit,stb*UWMd vril1< n 30 dJ of Pcrforrsti)crrq.
<br /> IF4vldual•a nsII mLiteg the dutfJ v sof the%c"rlft+arnpi ee Qm 6rwd Ot*r0�-tobar't.3,2011;rrlbexb6 tmined
<br /> b�elnal �rn�ln�I�t�il,t�r;�pLla'li+�5��ltrt�c�.
<br /> wN.e;�k thislbI IVa�13tt}I'C1&'iindivkfuaf(s)"Had Is apponcfeld D#i1'f1 AO fpiM. Thoaprldsd•l4i,erta Rtr�tiirr3i1�m'.Mbs GOAMM
<br /> F-6
<br /> '''��y b the Mform.aero in this►his s$cr;err, :
<br /> I11 .�.x..�.,,,rP-._.�.,�...,.._..._..._...�....__.��.�� �,...,, i..:...�r,.....�..,.._r,. �,.,:.-�,rT..�-r�
<br /> ,I NsrnL-01'irldhr$duo1l(,A)Ttained �. 1rrxYtial T#Ir�"ng Cato � Ffeesycrl+Itr+rsly 1*.a 1
<br /> ' `�.-. I I .• � I has �rrpl�rsir• I
<br /> �
<br /> .III. I I II r .Ill �I;I 1 1 I 'i. .I ;!2 :-!/
<br /> l III alrr,l. �FF 1/20Q5� ' '
<br /> I, I! I I'I1111 X111111 I 'I
<br /> P I Li
<br /> _ 'IIIIIII IIIj I,�•iI-III �I�!II i"I• ilr...::Larl--...1.;..� i.._. ..�.....�... ..�. _ � ., .r...., � .�. ..,.. �.jt.•.�.--ti.. .�___
<br /> Iy l I• I �.. i
<br /> _ ILJIi
<br /> i,jl I .VIII � IIIiII; I'I .I 11 I II I "'� ,
<br /> 1,r � III 'I I, I Ih'� �.•��� - — ..�..... --.�. .. 1
<br /> I I .�1.1111 'rl4l 11 II l�1 i•- I I I - � � --:
<br /> Ilrll III III II I III i1 IIII'111 ,I,, I _, �.•..___ _..�y.:_ '
<br /> III
<br /> II I .
<br /> h'. .-I'I'.L.ril x.•111 � - � �Y 11
<br /> 7
<br /> ..��� �_�.���..�,��.�—�w-ti.��i r...r.r�.�r—r�_•�...-_...�'�- .� '.� � � �� .tip.-�
<br /> 71
<br /> Ld
<br /> IV. CERTIFICATION 13Y DESIGNATED UST OPERATOR COHDUCTLNG THIS TRAINING
<br /> The fsl�clllty ernplayee9 Lietcd rlbo" havo completed the roquired tralnlnq 1n accIardance with CalifiornYa Coda of RequLttlem
<br /> Title 23.DIJAFJ 3,Chaptor I S. Srcdon 2715(c)and oil Lhe information provided hsreln Is rcaurata,,
<br /> Tr'alnirl Dail 6T Oporaror C- raal.ir• _
<br /> CERS CsYurL,i E RWOftra 6,,vn ,I a IdAwtir:al rrt ICC 11111--WAId Ud$Cal l!Sr t lyda,1vrxd DIgp Tw*
<br />
|