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DIVISION OF OCCUPATIONAL SAFETY AND HEALTH <br />4205 Technology Drive Suite 3 <br />Modesto, CA 95356 <br />209-545-7310 <br />209 -545 -7313 -fax <br />the <br />Oil <br />Monday 6 day of 201 February 2 I Robert Pike <br />- , . I <br />served the attached CaVOSHA form I BY, "intent to issue serious citation and employers response" to: <br />Jazz Group Inc. / Imperial Repair Group Inc. dba Imperial Truck Wash & Repair <br />(Name of Employer) <br />by giving the original and a copy of it to Manjeet Singh <br />(Employer or Employer Representative) <br />at 2142 W. Yosemite Avenue Manteca, CA 95337 <br />(Street Address, City, CA ZIP) <br />I declare under penalty of perju t the above De36ratlo-Mis, <br />e— <br />DATE :=Run= <br />OtvlcA <br />CITY <br />w7mmm monim, M., rryrrm "-= <br />I LN I 777-Tyw <br />2 4 102725157 G0994 314995093 2012 <br />Region District Inspection No. Engineer/IH ID No. Cat/OSHA Rpt No. Fiscal Year <br />CaVOSHA 2X (04/01/10) <br />