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PENALTY PAYMENT OPTIONS <br /> Penalties are due within 15 working days of GFipt of this Citation and Notification of Penalty <br /> unless contested. If you are appealing anem, <br /> ,of the citation, remittance is still due on all <br /> items that are not appealed. Enclosed for your use is a Penalty Remittance Form for payment. <br /> If you are paying electronically, please have the Penalty Remittance Form on-hand when you are <br /> ready to make your payment. The company name, inspection number, and Citation number(s) will <br /> be required in order to ensure that the payment is accurately posted to your account. Please go to <br /> www.dir.co.gov/dosh/CalOSHA_PaymentOption.htmi to access the secure payment processing site. <br /> Additionally, you must also mall the Penalty Remittance Form to the address below. <br /> If you are paying by check, return one copy of the Citation, along with the 9%rl" of ry <br /> Penalties Sheet and the Penalty Remittance Form and mail to: CE �Vt1LrJ1I <br /> Department.9f IpjJu5#ial Relations APR 09 2015 <br /> Calhier„A ?,,Qyn,Ing Office <br /> P. O. Box 420603 ENVIRONMENTAL <br /> San Francisco, CA 94142-0603 NCA'17-0n1=05onuCKR <br /> CAL/OSHA does not agree to any restrictions, conditions or endorsements put on any check or <br /> money order for less than the full amount due, and will cash the check or money order as if these <br /> restrictions, conditions, or endorsements do not exist. <br /> NOTIFICATION OF CORRECTIVE ACTION <br /> For violations which you do not contest, you should notify the Division of Occupational Safety and <br /> Health promptly by letter that you hdvr&fiaken' appropriate corrective action within the time frame <br /> set forth on this Citation and Notification of Penalty. Please inform the district office listed on the <br /> Citation by submitting the Cal/OSHA 160 and/or 161 forms with the abatement steps you have <br /> taken and the date the violation was abated, together with adequate supporting documentation, <br /> e.g., drawings or photographs of corrected conditions, purchase/work orders related to abatement <br /> actions, air sampling results, etc. The adjusted penalty for serious and general violations has already <br /> been reduced by 50% on the presumption that the employer will correct the violations by the <br /> abatement date. If the Cal/OSHA 161 is not received in the district office within 10 days following <br /> the abatement date, the abatement credit is revot causing the penalty to double. <br /> Note: Return the Cal/OSHA 160/161 forms to 'thio dis'ttict office listed on the Citation and as shown <br /> below: - <br /> Division of Occupational Safety and Health <br /> Modesto District Office <br /> 4206 Technology Drive, Suite 3 <br /> Modesto,'CA .95356 <br /> Tel hone: X209) 545-7310 <br /> "rax: fi2b9}5 5-7313 <br /> See pages I through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. <br /> Citation and Notification of Penalty Page 3 of 14 Cal/OSHA-2 Rev 12/2014 <br /> �piydy..y <br />