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Page 4 Fri Feb 17, 2012 2:59prn <br />Jazz Group, Inc. dba Imperial Truck Wash & Repair Inspection Nr. 314995093 Citation Nr. 01 ItenVGroup 003 <br />10nal Witness Documentation - List the name, address and phone number of each person having percipient information of the factual elements <br />e. After each name list the element numbers from above which the person is able to personally verity. <br />Citation Classification: <br />a. Assuming that an accident or exposure occurs, what are the likely consequences? <br />b. Management Knowledge (check all below that apply) <br />ElActual Management Knowledge <br />x Violation Common Practice at Jobsite <br />• Proximity of Supervisors to Violation <br />• Violation Readily Visible to Anyone Passing By <br />• Obligation Anticipated: Forseeable Hazards (i.e. Asbestos <br />Containing Construction Material In Older Buildings <br />Condition Existed Long Enough For Employer Awareness <br />ElConstructive Management Knowledge <br />Accident at Jobsite Previously from Same Violation(s) <br />Special Duty to inspect -Competent Person at Excavation <br />Employer Received Complaints from Other Employees of <br />Violation Condition <br />Other (please state) <br />Use the Documentation Worksheet to document evidence of any of the following: <br />d. Prior Violations <br />Intentional, Knowing, or Reckless Conduct (Willful) - Willful Elements Worksheet must be attached. <br />'allure to Abate. <br />E <br />Ara 'V <br />;p <br />Z Add transaction A Add G General 600.00 <br />OSHA -1 B/ IBIHprint(Rev. 9193) <br />