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STATE OF CALIFORNIA C' 'OSHA <br />DEPARTMENT OF INDUSTRIAL RELATIONS 4 !mbnologyDr, Ste 3 <br />DIVISION OF OCCUPATIONAL SAFETY AND HEALTH Modesto, CA 95356 <br />Talephon: (209) 545-7310 <br />Z114 pin 0 W41t1j1krdR110 1101 %110" _910,01 K.11 M Uyj RX <br />EMPLOYER: Jazz Group, Inc. / Imperial Repair Group, Inc. dba Imperial Truck Wash & Repair <br />ADDRESS: 21492 W. Yosemite <br />Manteca, CA 95337 <br />The law requires that violations observed during the inspection/investigation completed on 02/17/2012 of the place of employment <br />located at 2142 W. Yosemite, Manteca, CA be corrected within the time limit specified. Please notify the Division as soon as these <br />conditions have been corrected by returning this completed form. Your response by completing, signing and mailing this farm to <br />g rin <br />the issuing office on or before the compliance date may avoid a follow-up inspection of your facilities. Failure to timely complete <br />and return this form may result in issuance of a citation and civil penalty for violation of 8CCR 340.4(c). <br />NOTE: This form does not serve as a request for a time extension. If there are <br />serious problems beyond your control that prevent meeting a specified abatement <br />date, contact the Division early, well within the 15 -day limit allowed for an appeal. <br />M ME <br />rm-n-w5f ocynnmav T-1 <br />UNSAFE CONDITIONS AND DATE OF ABATEMENT. <br />[ ] Continued on additional page <br />This signed statement or a <br />summary shall be posted for three <br />(3) working days at or near each <br />place the regulatory and/or general <br />violation(s) referred to in the <br />citation occurred. <br />All affected employees and their representatives have been informed about abatement activities referenced in this document in <br />conformance with 8CCR Section 340.4(8). L I Yes I I No <br />This certifies that all unsafe conditions listed in the Division's citation dated have now been corrected and all submitted abatement <br />information is accurate. <br />Signature: <br />am <br />Title: <br />OFFICE USE ONLY <br />Division Engineer/Industrial Hygienist: —Date <br />District Manager: —Date <br />Close/Comments <br />Region 2 District 4 Inspection No, 214995093 Identification No, G0994 Cal/OSHA Rpt. No. & Fiscal Year 034-12 <br />Date mailed or delivered: FEB 2 8 2012 <br />