U.S. Department of Labor Occupational Safety and Health Administration Denver Commons Office Plaza 111 Main St., Suite 111 Denver, CO 11111 Phone: (111) 111-1111 FAX: (222) 222-2222 Citation and Notification of Penalty To: Inspection Number: 111111111 Acme Widget Factory Inspection Date(s): 04/15/2015-04/16/2015 and its successors Issuance Date: 08/21/2015 1 Factory Lane Inglewood, CO 11111-1111 Inspection Site: The violation(s) described in this citation and 1 Factory Lane Notification of Penalty is (are) alleged to have Inglewood, CO 11111-1111 occurred on or about the day(s) the inspection was made unless otherwise indicated within the description given below. This Citation and Notification of Penalty (this citation) describes violations of the Occupational Safety and Health Act of 1970. The penalty(ies) listed herein is (are) based on these violations. You must abate the violations referred to in this citation by the dates listed, and pay the penalties proposed unless, within 15 working days (excluding weekends and federal holidays) from your receipt of this Citations and Notification of Penalty, you mail a notice of contest to the U.S. Department of Labor Area Office at the address shown above. Please refer to the enclosed booklet (OSHA 300) which outlines your rights and responsibilities and should be read in conjunction with this form. Issuance of this citation does not constitute a finding that a violation of the Act has occurred unless there is a failure to contest as provided for in the Act or, if contested, unless this citation is affirmed by the Review Commission or a court. Posting – The law requires that a copy of this Citation and Notification of Penalty be posted immediately in a prominent place at or near the location of the violation(s) cited herein, or, if it is not practicable because of the nature of the employer’s operations, where it will be readily observable by all affected employees. This citation must remain posted until the violation(s) cited herein has (have) been abated, or for 3 working days (excluding weekends and federal holidays)—whichever is longer. The penalty dollar amounts need not be posted and may be marked out or covered up prior to posting. Informal Conference – An informal conference is not required. However, if you wish to have such a conference you may request one with the area director during the 15 working day contest period. During such an informal conference, you may present any evidence or views which you believe would support an adjustment to the citation(s) and/or penalty(ies). If you are considering a request for an informal conference to discuss any issues related to this Citation and Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be submitted to the area director within 15 working days of your receipt of this citation. The running of this contest period is not interrupted by an informal conference. If you decide to request an informal conference, please complete, remove, and post the page 4 Notice to Employees next to this Citation and Notification of Penalty as soon as the time, date, and place of the informal conference have been determined. Be sure to bring to the conference any and all supporting documentation of existing conditions, as well as any abatement steps taken thus far. If conditions warrant, we can enter into an informal settlement agreement which amicably resolves this matter without litigation or contest. Right to Contest – You have the right to contest this Citation and Notification of Penalty. You may contest all citation items or only individual items. You may also contest proposed penalties and/or abatement dates without contesting the underlying violations. Unless you inform the area director in writing that you intend to contest the citation(s) and/or proposed penalty(ies) within 15 working days after receipt, the citation(s) and the proposed penalty(ies) will become a final order of the Occupational Safety and Health Review Commission and may not be reviewed by any court or agency. Penalty Payment – Penalties are due within 15 working days of receipt of this notification unless contested. (See the enclosed booklet and the additional information provided related to the Debt Collection Act of 1982.) Make your check payable to “DOL-OSHA”. Please indicate the inspection number on the remittance. OSHA does not agree to any restrictions or conditions or endorsements put on any check or money order for less than the full amount due and will cash the check or money order as if these restrictions, conditions, or endorsements do not exist. Notification of Corrective Action – For each violation which you do not contest, you are required by 29 CFR 1903.19 to submit an Abatement Certification to the area director of the OSHA office issuing the citation, identified above. The certification must be sent by you within 10 calendar days of the abatement date indicated on the citation. For willful and repeat violations, documents (e.g., photos, copies of receipts, training records) demonstrating that abatement is complete must accompany the certification. Where the citation is classified as serious and the citation states that abatement documentation is required, documents such as those described above are required to be submitted along with the abatement certificate. If the citation indicates that the violation was corrected during the inspection, no abatement certification is required for that item. All abatement verification documents must contain the following information: 1) Your name and address; 2) the inspection number (found on the front page); 3) the citation and citation item number(s) to which the submission relates; 4) a statement that the information is accurate; 5) the signature of the employer or employer’s authorized representative; 6) the date the hazard was corrected; 7) a brief statement of how the hazard was corrected; and 8) a statement that affected employees and their representatives have been informed of the abatement. The law also requires a copy of all abatement verification documents, required by 29 CFR 1903.19, to be sent to OSHA and also be posted at the location where the violation appeared and the corrective action took place. Employer Discrimination Unlawful – The law prohibits discrimination by an employer against an employee for filing a complaint or for exercising any rights under this Act. An employee who believes that he/she has been discriminated against may file a complaint no later than 30 days after the discrimination occurred with the U.S. Department of Labor Area Office at the address shown above. Employer Rights and Responsibilities – The enclosed booklet (OSHA 300) outlines additional employer rights and responsibilities and should be read in conjunction with this notification. Notice to Employees – The law gives an employee or his/her representative the opportunity to object to any abatement date set for a violation if he/she believes the date to be unreasonable. The contest must be mailed to the U.S. Department of Labor Area Office at the address shown above and postmarked within 15 working days (excluding weekends and federal holidays) of the receipt by the employer of this Citation and Notification of Penalty. Inspection Activity Data – You should be aware that OSHA publishes information on its inspection and citations activity on the Internet under the provisions of the Electronic Freedom of Information Act. The information related to your inspection will be available 30 calendar days after the citation issuance date. You are encouraged to review the information concerning your establishment at www.osha.gov. If you have any dispute with the accuracy of the information displayed, please contact the office. U.S. Department of Labor Occupational Safety and Health Administration NOTICE TO EMPLOYEES OF INFORMAL CONFERENCE An informal conference has been scheduled with OSHA to discuss the citation(s) issued on 08/21/21015. The conference will be held at the OSHA office located at Denver Commons Office Plaza, 111 Main St., Suite 111, Denver, CO 11111 on ________ at __________. Employees and/or representatives of employees have a right to attend an informal conference. CERTIFICATION OF CORRECTIVE ACTION WORKSHEET Inspection Number: Company Name: Inspection Site: Issuance Date: List the specific method of correction for each item on this citation in this package that does not read "Corrected During Inspection" and return to: U.S. Department of Labor - Occupational Safety and Health Administration, Denver Commons Office Plaza, 111 Main St., Suite 111, Denver, CO 11111 Citation Number ____ and Item Number ____ was corrected on _______________ By (Method of Abatement):_______________________________________________________________ Citation Number ____ and Item Number ____ was corrected on _______________ By (Method of Abatement): _______________________________________________________________ Citation Number ____ and Item Number ____ was corrected on _______________ By (Method of Abatement): _______________________________________________________________ Citation Number ____ and Item Number ____ was corrected on _______________ By (Method of Abatement): _______________________________________________________________ Citation Number ____ and Item Number ____ was corrected on _______________ By (Method of Abatement): _______________________________________________________________ Citation Number ____ and Item Number ____ was corrected on _______________ By (Method of Abatement): _______________________________________________________________ I certify that the information contained in this document is accurate and that the affected employees and their representatives have been informed of the abatement. ________________________ ____________________________ Signature Date ________________________ ____________________________ Typed or Printed Name Title NOTE-: 29 USC 666(g) whoever knowingly makes any false statements, representation or certification in any application, record, plan or other documents filed or required to be maintained pursuant to the Act shall, upon conviction, be punished by a fine of not more than $10,000 or by imprisonment of not more than 6 months or both. POSTING: A copy of completed Corrective Action Worksheet should be posted for employee review U.S. DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION CERTIFICATE OF CORRECTION The undersigned certifies that on ______________, all of the violations cited on OSHA Citation # ____________ issued on _________, were corrected and that a copy of this certificate was posted on _________ in a manner and place for review by affected employees. ______________________ Employer’s Signature U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 The alleged violations below have been grouped because they involve similar or related hazards that may increase the potential for injury or illness. Citation 1 Item 1a Type of Violation: Serious 29 CFR 1910.1025(c)(1) Exposure levels to lead fumes during welding operations were not kept below the established permissible exposure level (PEL). (a) Location – Frame Assembly Area On 04/15/15, a MIG welder in the frame assembly area was exposed to lead at an airborne time weighted average (TWA) exposure of 100 μg/m3. This exposure was approximately 2 times the permissible exposure limit (PEL) of 50 ug/m3. This exposure was calculated from a sample collected over a 410 minute period; a zero increment was included for the 70 minutes not sampled. (b) Location – Frame Assembly Area On 04/15/15 a MIG welder in the frame assembly area was exposed to lead at an airborne time weighted average (TWA) exposure of 80 μg/m 3. This exposure was approximately 2 times the permissible exposure limit (PEL) of 50 ug/m3. This exposure was calculated from a sample collected over a 400 minute period; a zero increment was included for the 80 minutes not sampled. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date by which violation must be abated: 09/28/2015 Proposed Penalty: $7000.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 1b Type of Violation: Serious 29 CFR 1910.1025(e)(1)(ii): Where an employee was exposed to lead above the permissible exposure limit, but for 30 days or less per year, engineering controls were not implemented to reduce exposures to 200 ug/m3: Engineering controls were not implemented to reduce the exposure to employees overexposed to Lead. Engineering controls usually effective in these circumstances include, but are not limited to, the following: 1. Modification of the existing ventilation system to improve capture velocity at the ventilation hoods. 2. Modification of ventilation hoods to better collect metal fumes, Abatement Steps STEP 1: Effective respirators shall be provided and used by all employee(s) as an interim measure. Abatement must be completed by September 1, 2015. U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 STEP 2: Submit to the Area Director a written detailed plan of abatement outlining a schedule for the implementation of engineering measures to control employee exposures as referenced in this citation. This plan shall include, at a minimum, target dates for the following actions which must be consistent with the dates required by this citation. a) Evaluation of the extent and location of the hazard source. b) Evaluation of control measure options. c) Selection of optimum control method(s). d) Determination of control measure design. e) Ordering and delivery of equipment and material(s). f) Installation of control measures. g) Training of employees in proper operation and maintenance of newly-implemented control measures. h) Assurance of effective performance of control measures. All proposed control measures shall be evaluated for each particular use by a technically qualified person. Abatement must be completed by September 1, 2015. STEP 3: Correction should have been completed by the implementation of feasible engineering controls and air sampling results to verify the effectiveness in achieving compliance. Abatement must be completed by September 1, 2015. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 2 Type of Violation: Serious 29 CFR 1910.134(c)(1): A written respiratory protection program that included the provisions in 1910.134(c)(1)(i) - (ix) with worksite specific procedures was not established and implemented for required respirator use: No written program was developed for employees who were overexposed to lead and who are required to wear respirators while working in the frame assembly area. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $4900.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 3 Type of Violation: Serious 29 CFR 1910.13 4(e)(1): The employer did not provide a medical evaluation to determine the employee’s ability to use a respirator, before the employee is fit-tested or required to use the respirator in the workplace: At least three employees who were required to use respiratory protection while working in the frame assembly area were not provided a medical evaluation. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $3500.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 The alleged violations below have been grouped because they involve similar or related hazards that may increase the potential for injury or illness. Citation 1 Item 4a Type of Violation: Serious 29 CFR 1910.134(f)(1): The employer did not ensure that employees using a tight-fitting facepiece respirator pass an appropriate qualitative fit test (QLFT) or quantitative fit test (QNFT) as stated in 29 CFR 1910(f): No fit testing was done for employees who were overexposed to lead and who are required to wear respirators while working in the frame assembly area. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $4900.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 4b Type of Violation: Serious 29 CFR 1910.134(g)(1)(i)(A): Respirators with tight-fitting facepieces were worn by employees who had facial hair that came between the sealing surface of the facepiece and the face or that interfered with valve function: Two employees, who wore half mask 3M respirators, had beards which interfered with the face seal. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 5 Type of Violation: Serious 29 CFR 1910.134(k)(1): The employer did not ensure that each employee can demonstrate knowledge of at least 29 CFR 1910.134(h)(1)(i) through(vii): At least three employees who were required to use respiratory protection while working in the frame assembly area were not trained in the use of respirators. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $4900.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 6 Type of Violation: Serious 29 CFR 1910.147(c)(1): The employer did not establish a program consisting of an energy control procedure and employee training to ensure that before any employee performed any servicing or maintenance on a machine or equipment where the unexpected energizing, start up or release of stored energy could occur and cause injury, the machine or equipment would be isolated, and rendered inoperative in accordance with 29 CFR 1910.147(c)(4): No energy control program was developed for employees who work on equipment including, but not limited to, the mechanical presses. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $2800.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 7 Type of Violation: Serious 29 CFR 191 0.1200(f)(5)(i): The employer did not ensure that each container of hazardous chemicals in the workplace was labeled, tagged or marked with the identity of the hazardous chemical( s) contained therein: a) At the jobsite - The employer did not ensure that each container of hazardous chemicals in the workplace was labeled with legible markings. The labels for three 5 gallon jugs containing clear liquids were not labeled. Employees in the area could not determine what the liquids were. Observed on 04/15/2015 Abatement certification required within 10 days after abatement date. The certification shall include a statement that abatement is complete, date and method of abatement, and state employees and their representatives were informed of this abatement. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $3000.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 8 Type of Violation: Serious 29 CFR 1910.1200(g)(8): The employer did not maintain in the workplace copies of the required safety data sheets for each hazardous chemical, and did not ensure that they were readily accessible during each work shift to employees when they were in their work area( s) The employer did not maintain safety data sheets to assist employees working with hazardous chemicals such as, but not limited to, Methyl Ethyl Ketone, Acetone, and Sulfuric Acid. Observed on 04/15/2015. Abatement certification required within 10 days after abatement date. The certification shall include a statement that abatement is complete, date and method of abatement, and states employees and their representatives were informed of this abatement. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $3000.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 9 Type of Violation: Serious 29 CPR 191 0.178(1)(1 )(ii): Prior to permitting an employee to operate a powered industrial truck (except for training purposes), the employer shall ensure that each operator has successfully completed the training required by this paragraph (1), except as permitted by paragraph (1)(5): a. The employer did not ensure that employees received a combination of formal instruction (e.g., lecture, discussion, interactive computer learning, video tape, written material), practical training (demonstrations performed by the trainer and practical exercises performed by the trainee), and an evaluation of the operator's performance in the workplace prior to permitting each employee to operate a powered industrial truck. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $5500.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 10 Type of Violation: Serious 29 CFR 1910.305(g)(l)(iv)(A): Flexible cords and/or cables were used as a substitute for the fixed wiring of a structure: Employees were exposed to electrical shock hazards while operating equipment such as, but not limited to computers controlling production equipment which were plugged into temporary electrical wiring: a) Management had rerouted some of the computers from the press area to a neighboring office by using an electrical cord attached to a surge protector and routing it though the AC vent to the office. b) At least 5 relocatable power taps were being used with one electrical wall 120V receptacle to provide power to at least 10 electrical devices such as, but not limited to, computers in the manufacturing area, office phones, cell phone chargers, and printers. c) Several extension cords ran across the floor to computers in the production area and were not secured. U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM. Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $7000.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 11 Type of Violation: Serious OSH Act of 1970 Section 5(a)(1): The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employers, in that employees were exposed to chemicals that could be injurious to the eyes with no emergency eyewash within 300 feet. a. Employees in the parts washing area were using large quantities of methyl ethyl ketone and acetone to clean parts. The process required employees to place large parts into a solvent cleaning station and spray the parts with Solven100®, a mixture containing 75% MEK and 25% acetone. The spraying process created a high risk of the chemical splashing into the employee’s eyes. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $5500.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 1 Item 12 Type of Violation: Serious 29 CFR 1910.138(a): The employer did not select and require employee(s) to use appropriate hand protection when the employees hands were exposed to hazards such as those from skin absorption of harmful substances and chemical burns: a. Employees in the parts washing area were using large quantities of methyl ethyl ketone and acetone to clean parts. The process required employees to place large parts into a solvent cleaning station and spray the parts with Solven100®, a mixture containing 75% MEK and 25% acetone. The employee was then required to use a rag dipped in the solution to wipe down the parts. The employee was not furnished with any impervious gloves. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $7000.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 2 Item 1 Type of Violation: Willful 29 CFR 1910.1025(d)(2): An initial determination was not made to determine if any employee may be exposed to lead at or above the action level: No air sampling was done to determine if employees were over exposed to lead during welding operations. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $49000.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 The alleged violations below have been grouped because they involve similar or related hazards that may increase the potential for injury or illness. Citation 2 Item 2a Type of Violation: Willful 29 CFR 1910.1025(1)(1)(i): Employee(s) working in an area where there is potential exposure to airborne lead at any level were not informed of the content of Appendices A and B of this regulation: No training was done for employees who work on the site casting lead containing alloys. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $49000.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 2 Item 2b Type of Violation: Willful 29 CFR 1910.1025 (1)( 1 )(ii): A training program was not instituted and required for all employees who were subject to lead exposure at or above the action level, or for whom the possibility of skin or eye irritation existed: No training was done for employees who were overexposed to lead while welding in the frame assembly area. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 The alleged violations below have been grouped because they involve similar or related hazards that may increase the potential for injury or illness. Citation 2 Item 3a Type of Violation: Willful 29 CFR 1910.1 200(e)( 1): The employer did not develop, implement, and/or maintain at the workplace a written hazard communication program which describes how the criteria specified in 29 CFR 1910.1200(f), (g), and (h) will be met: No written hazard communication program was developed for employees who work on the site and are exposed to hazardous chemicals including, but not limited to, lead, methyl ethyl ketone, acetone, and sulfuric acid. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 Proposed Penalty: $49000.00 U.S. Department of Labor Inspection Number: 111111111 Occupational Safety and Health Administration Inspection Date(s): 04/15/2015-04/16/2015 Issuance Date: 08/21/2015 Citation and Notification of Penalty Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Citation 2 Item 3b Type of Violation: Willful 29 CFR 1910.1200(h)(1): Employees were not provided with effective information and training as specified in 29 CFR 1910.1200 (h)(2) and (3) on hazardous substances in their work area at the time of their initial assignment and whenever a new hazard was introduced into their work area: No training was provided for employees who work on the site and are exposed to hazardous chemicals including, but not limited to, lead, methyl ethyl ketone, acetone, and sulfuric acid. ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM Date By Which Violation Must be Abated: 09/28/2015 U.S. Department of Labor Occupational Safety and Health Administration Denver Commons Office Plaza 111 Main St., Suite 111 Denver, CO 11111 Phone: (111) 111-1111 FAX: (222) 222-2222 INVOICE / DEBT COLLECTION NOTICE Company Name: Acme Widget Factory Inspection Site: 1 Factory Lane, Inglewood, CO 11111-1111 Issuance Date: 08/21/2015 Summary of Penalties for Inspection Number 111111111 Citation 1, Serious $59000.00 Citation 2, Willful $147000.00 TOTAL PROPOSED PENALTIES S206000.00 To avoid additional charges, please remit payment promptly to this Area Office for the total amount of the uncontested penalties summarized above. Make your check or money order payable to: “DOLOSHA”. Please indicate OSHA’s Inspection Number (indicated above) on the remittance. OSHA does not agree to any restrictions or conditions or endorsements put on any check or money order for less than the full amount due, and will cash the check or money order as if these restrictions or conditions do not exist. If a personal check is issued, it will be converted into an electronic fund transfer (EFT). This means that our bank will copy your check and use the account information on it to electronically debit your account for the amount of the check. The debit from your account will then usually occur within 24 hours and will be shown on your regular account statement. You will not receive your original check back. The bank will destroy your original check, but will keep a copy of it. If the EFT cannot be completed because of insufficient funds or closed account, the bank will attempt to make the transfer up to 2 times. Pursuant to the Debt Collection Act of 1982 (Public Law 97-365) and regulations of the U.S. Department of Labor (29 CFR Part 20), the Occupational Safety and Health Administration is required to assess interest, delinquent charges, and administrative costs for the collection of delinquent penalty debts for violations of the Occupational Safety and Health Act. Interest: Interest charges will be assessed at an annual rate determined by the Secretary of the Treasury on all penalty debt amounts not paid within one month (30 calendar days) of the date on which the debt amount becomes due and payable (penalty due date). The current interest rate is one percent (1%). Interest will accrue from the date on which the penalty amounts (as proposed or adjusted) become a final order of the Occupational Safety and Health Review Commission (that is, 15 working days from your receipt of the Citation and Notification of Penalty), unless you file a notice of contest. Interest charges will be waived if the full amount owed is paid within 30 calendar days of the final order. Delinquent Charges: A debt is considered delinquent if it has not been paid within one month (30 calendar days) of the penalty due date or if a satisfactory payment arrangement has not been made. If the debt remains delinquent for more than 90 calendar days, a delinquent charge of six percent (6%) per annum will be assessed accruing from the date that the debt became delinquent. Administrative Costs: Agencies of the Department of Labor are required to assess additional charges for the recovery of delinquent debts. These additional charges are administrative costs incurred by the Agency in its attempt to collect an unpaid debt. Administrative costs will be assessed for demand letters sent in an attempt to collect the unpaid debt. ____________________ _____________ John Smith Date Area Director 
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