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SHALLNOiEMi'LOYANYPERSONINANYMANNEHSO�ST08ECOMESUBJECTTOTME i Uj WORKERS'COMPENSATpNUWSOFCAUFORNIA�NOAGREE7WITIFISHOlAOBECOME -INSPECTIONFEE � � ' � ' .. .__ . ...... . . , SUaIECTTOTHEWORKERS'COMVENSATqNPHOV1510N50FSECTiON07ooOFTHELABOR � , , O CODE,ISHAL�FORTMWITHLOMPLVWITNTNOSfPROV1510N5. �SSUANCE �� . . . .... ....._,.. ."'_ .. ..... .. ... . p DATE: APPLICANT. SMIP . .. .. . . . . .- . ... ... .. ... ... .. , � WARNIN(3:FAILUfiEIOSECUREVJOfU(ERS'COAIPENSATIQVCAVERAG[ISUNLAWM.ANDSNALLBE ' .ENERGYP/C - � ' ... . ... .� •J 1 �" . LL SU6J[CTANENPLOVENTOCRIMPlALPENl�LTIESANDCMLFWESUPTOONEHUfJOREDiHOUSAND ENERGYPERMIT . 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