Loading...
HomeMy WebLinkAbout0230 FALMOUTH ROAD/RTE 28 - Health 230 Falmouth Rd lI 293-033 Hyannis � Y&Z SOT) TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 0 satisfactory 2.Printers BOARD OF I- ,EALT�H 3.Auto Bony shops ,� unsatisfactory- 4.Manufacturers COMPANY G116 S j (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS m Class: 7.Miscellaneous p!� U'J� QUANTITIES AND TORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIAL �� 1 ,, IN OUT IN OUT IN OUT #&gallons Age ITest Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) O transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: Me CA—) r3k LcL)gC4 A I U Li-) �... I 11 .A I N /DOM f)(_ //1 /e7 A P YTV S od DISPOSAL/RECLAMATION /R �®A S� � 1, anita I`Y Sewage 2. Supply �. ater Town Sewer ublic C; A&L r4jenmoluvw On-site ()Private 3. Indoor Floor Drains YES NO Gpo U O Holding tank:MDC c- O Catch basin/Dry well c J Q O On-site system G rworU 4. Outdoor Surface drains:YES NO WIDE © ( ff O Holding tank: MDC �L S ® eF � _ WL, O Catch basin/Dry well Ly (;� .� <_ O On-site system 5. Waste Transporter Name Gf Hauler Destination Waste Product 1. 7=3 H Al DL b l I 1 l CA LS YES NO 2. / f GXW 0 �^ Person (s) Interviewed Ins0�peh&' TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF'BUSINESS: ►k o�- Mail To: BUSINESS LOCATION: J 6 � .��r�ir,r_.c �� c� . !-jUarrii 1 4 Board of Health Town of Barnstable MAILING ADDRESS: GcLejuc ) P.O. Box 534 - TELEPHONE NUMBER: U `-7 7�- � '�' Hyannis, MA 02601 CONTACT PERSON: J .. ir-) EMERGENCY CONTACT TELEPHONE NUMBER: 56A -96 — 79d,�-z Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, ' s li ? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners '► Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants t Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) . Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing'ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers /O Swimming pool chlorine Car wash detergents 10QL S Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, a as` Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): `(dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners r White Copy- Health Department/ Canary Copy-Business � TOWNOF BARNSTABLE T {' _BAR-W 375 , Ordinance or Regulation WARNING NOTICE g �,l �'�rn D, a Name of Off ender/Mana ender/Manager h � �_ � �-""��6�' 6/'� Address of Offender (.c�' c-feaf MV/MB Reg.# Village/State/Zip Le 1�-4 i , Business Nameam`,pm; on / 19U✓ 1Z_L Business Address 404^,f� f)Vim- _J -1- I Signature of Enforcing Officer Village/State/Zip Location of Offense a 3 ® A 44 11 I nforcing Dept/Division \� Offense �C/� c �� Facts a/, This will serve only As a warning. At this time no legal a0tion has)been taken. It is the -goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will I �r sult in appropriate legal action by the Town. l/ V/0 1N ,/-ems TOWN-`OF BARNSTABLE BAR-W 375 ;Ordinance or Regulation WARNING NOTICE - • t � Name of Offender/Manager ~'"' L S 6ke�c,. Address of Offender y ►t r2.rr C1- ' MV/MB Reg.# Village/State/Zip 4 /cfi'-.. -;k, Business Name am m; on 19d Business Address ( tll��a- G Signature of Enforcing Officer �-- Village/State/Zip Location of Offense c l p f ���-.� ', ^` 0,4*! Enforcing Dept/Division �(s1 Offense t ® r.,,hA Facts ' w; P{ ` f , . r r��., l U" ! 1j1d v„°°' I W' �.�'i7"13 ( ^� �.` •.� �'-P�f. 1, This will serve only as, a warning. At this)time no legal aco`tion has een` taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will r s.ult in appropriate legal action by the Town. TOWN OF BMNSTABLE BAR-W 375 -Ordinance or Regulation WARNING NOTICE Name of Offender/Managert1 Address of Offender My/MB Reg.# Village/State/Zip Lo 1r' r�, 0 ,5 .;L. Business Name n -' am/p on / 19>r� Business Address Signature of Enforcing Officer Village/State/Zip ' '' yy t ' Location of Offense > 'Enforcing Dept/Division k'j Offense (�� , .. Facts 1 t r This will serve only ,-,as a warning. At this :time no legal action has/-been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. �1 J �M �f��'f yr '' Y' "j cr' R293 033. INVALID FUNCTION I-00O2:30 ROUTE 28 CTY07 TDS 40o HY KEY 205398 -----MAILING ADDRESS------- PCA3011 Pcsoo YROO PARENT 0 UNIFAlvl INC MAP AREAC004 iv MTGoOOo 1:317 MIDDLESEX ST SPI SP2 SP3 LIT UT2 . 83 SO FT 4348 LOWELL MA 01852 AYB15y7l EYB1971 OBS CONST 37030o- o0oo LAND 24380o IMF, 168000 OTHER ----LEGAL.. DESCRIPTION---- TRUE MKT 4118.00 REA CLASSIFIED #1 AND I.: 243, 80o ASD LND 24:3800 ASD IMP 168oOO ASD OTH #BLDG(S) -CARD-1 :3 23, 900 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #BLDG(S) -CARD-2 1.44, 100 TAX EXEMPT #PL 230 FALMOUTH RD/RTE 28 RESIDENT"L #RR 1388 020o OPEN SPACE #DL A-9 & 95 COMMERCIAL 411800 411800 4118oO #TAS 25,,-=:. 04 1 NDUSTR I AL #FAB 78. 86 EXEMPTIONS SALE00/00 PRICE ORBC42208 AFD LAST AC*TIVII-Yo8/()'.--;/`94 PCRY R V F Window PCR/l at BARNSTABLE (28) 1p out 61-7 - Occupational EDUCATIONAL SERVICES The Division provides a wide range of Health educational services. These services include a library that is open to the public, publications, speakers,and occasional seminars on occupational health issues. Under the Massachusetts Right-To-Know, Programs the. Division registers individuals as third-party trainers. • Educational materials, to help employers and employees with right-to-know laws, Material Safety Data Sheets (MSDSs), and health hazards of workplace products, are also available.. For further informationon these services or any of PREVENTION the above listed programs or services, please contact: - DETECTION EVALUATION Massachusetts Department of Labor and ' Industries Division of Occupational Hygiene CONTROL 1001 Watertown Street West Newton, MA 02165 (617) 969-7177 No. 16626 Supersedes No. 1662 10/94 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF LABOR Honorable Christine E. Morris, Secretary of Labor/Commissioner Department of Labor and Industries Peter Blaisdell, Operations Manager Division of occupational Hygiene Paul Aboody, Director MASSACHUSETTS DIVISION OF OCCUPATIONAL HYGIENE The Division of Occupational Hygiene (DOH) was established by ASBESTOS PROGRAM 7(C)l OSHA CONSULTATION the Legislature in 1934. For over sixty years, the Division has carried PROGRAM out its mandate to investigate workplaces for the detection and prevention of occupational health problems. The following services, The Asbestos Program performs Jointly funded by the Massac- provided by the Division,assist employers,employees,unions and state surveys, in the public and private husetts Department of Labor and and local agencies in creating healthier and safer working conditions for sector, to determine the exposure Industries and OSHA, the 7(C)1 Massachusetts workers. risk to occupants, and to inventory OSHA Consultation Program assis- asbestos containing material(ACM) is employers in establishing and in buildings. A comprehensive sur- maintaining a safe and healthful OCCUPATIONAL HYGIENE vey can include four objectives: workplace. This goal is accom- SERVICES (1) maintain ACM in good condi- plished by confidential on-site tion, health and safety surveys. These American Industrial Hygiene Assoc- (2) ensure proper cleanup of services are provided at no cost, The Occupational Hygiene iation, it is also an Occupational asbestos fibers previously released, but only upon an employer's Program investigates potential Safety and Health Administration (3) prevent further release of request. workplace health hazards upon the (OSHA) approved laboratory for asbestos fibers, and request of an employee, a health blood lead analysis. In this latter (4) monitor the condition of the As part of a survey, air samples professional or a governmental role, it provides a cost effective ACM. may be collected to determine the agency. Investigations are made in and convenient service, to the pub- _ Sample results and control level of employee exposures to a variety of work settings ranging lic at large, and to the Deleading measures are described in a hazardous chemicals. The results from foundries to offices. The in- Industry for which it provides med- technical report. are included in a report sent to the vestigations may include air sam ical monitoring services for a fee. employer. Hazards and violations piing for hazardous substances- The principal role of this laboratory As the Governor's designee,the of OSHA standards are described, evaluation of ventilation systems; is to evaluate materials and air Program is involved in the federally and specific corrective recommend- and examination of work practices. samples, that are submitted by the mandated Asbestos Hazard Emer- ations are.made. There are no pe- A written report,which includes engineers of the Division, inspec- gency Response Act (AHERAI. nalties, fines or citations issued. test results and recommendations tors from the Lead and Asbestos This regulation requires schools to When serious violations of OSHA for controlling eolling workplace health progam, and, on occasion, author- inventory ACM and develop respo- standards are found, target dates hazards .sent to the employer. ized representatives of employees nse actions to reduce or eliminate are established for abatement of public records in the Commonwealth. The labora- asbestos exposure. the hazards. are These reports p tort' is not intended to function in available upon written request. Under Massachusetts law, lab- an emergency or research mode, The Program, in conjunction A 7(C11 consultation can help an oratories must report elevated but rather, to provide relatively with the Division of Industrial employer to establish or strengthen standard or routine procedures. On Safety, ensures that asbestos an employee safety and health blood lead levels to the Divisions staff, an occupational health nurse Occupational Lead Poisoning Reg_ abatement work complies with 453 program and can include training OccOcc Registry staff provide is available to assist employers, CMR 6.00, The Removal, Contain- and education upon request. educational material to workers employees, and health care provid- ment and Encapsulation of Asbes- Contact this office for a free health regarding lead exposure, and DOH ers who have questions regarding tos. consultation. You may contact the industrial hygienists investigate issues which include: reproductive This regulation requires that those Program Manager and/or request a workplaces for lead hazards. The health hazards, and infectious dis- who work with ACM (i.e., contrac- safety or health consultation by Industrial Hygiene Laboratory pro- ease concerns. Training on blood- tors, labs, consultants, trainers, telephoning (617) 727-3463. vides analytical support for the borne diseases has been provided etc.) must be licensed or certified Division. Fully accredited by the to public sector employees. by the Department. r ((JJ _ n -� � �e�artnerzf �� aizcr��.�ustr�e.�s /001 `J/atetvo-ayi cJl�Lef Ifest 1eu"t0�; _ jl 02>66 TEL: (617) 727-3463 FAX: (617) 727-4581 THE OSHA CONSULTATION SERVICE Using a free consultation service largely funded by the U.S. Occupational Safety and Health Administration (OSHA) , employers can find out about potential hazards at their worksites, improve their safety management systems,. and even qualify for a one-year exemption from routine OSHA inspections. The service is delivered by state governments using well-trained professional staff. Most consultations take place on-site, though limited services away from the worksite are available. Primarily targeted for smaller businesses, this safety and health consultation program is completely separate from the OSHA inspection effort. In addition, no citations are issued or penalties proposed. It's confidential, too. Your name, your firm's name, and any information you provide about your workplace, plus any unsafe or unhealthful working conditions that the consultant uncovers, will not be reported routinely to the OSHA inspection staff. Your only obligation will be to commit yourself to correcting serious job safety and health hazards-- a commitment which you are expected to make prior to the actual visit and carry out in a timely manner. GETTING STARTED: Since consultation is a voluntary activity, you must request it. Your telephone call or letter sets the consultation in motion. The consultant will discuss your specific needs with you and conduct research useful in preparing to assist you. OSHA encourages a complete review of your firm's safety and health situation; however, if you wish you may limit the visit to one or more specific problems. OPENING CONFERENCE: When the consultant arrives at your worksite for the scheduled visit, he or she will first meet with you in an opening conference to briefly review the consultant's role and the obligation you incur as an employer. WALK-THROUGH: Together, you and the consultant will examine conditions in your workplace. OSHA strongly encourages maximum employee participation in the walk-through. Better informed and more alert employees can more easily work with you to identify and correct potential injury and illness hazards in your workplace. Talking with employees during the walk-through helps the consultant identify and judge the nature and extent of specific hazards. The consultant will study your entire plant or specific operations you designate and discuss the applicable OSHA standards. Consultants also will point out other safety and health risks which might not be cited under OSHA standards, but which nevertheless may pose safety or health risks to your employees. They may suggest other measures such as self- inspection and safety and health training to prevent future hazardous situations. A comprehensive consultation also includes: (1) appraisal of all mechanical and environmental hazards and physical work practices; (2) appraisal of the present job safety and health program or establishment of one; (3) a conference with management on findings; (4) a written report of recommendations and agreements; and (5) training and assistance with implementing recommendations. CLOSING CONFERENCE: The consultant will then review detailed findings with you in a closing conference. You will learn not only what you need to improve, but what you are doing right, as well. At that time you can discuss problems, possible solutions and abatement periods to eliminate or control any serious hazards identified during the walk-through. In rare instances, the consultant may find an "imminent danger" situation during the walk-through. If so, you must take immediate action to protect all employees. In certain other situations-- those which would be judged a "serious violation" under OSHA criteria-- you and the consultant are required to develop and agree to a reasonable plan and schedule to eliminate or control that hazard. The consultants will offer general approaches and options to you. They may also suggest other sources for technical help. ABATEMENT AND FOLLOW THROUGH: Following the closing conference, the consultant will send you a written report explaining the findings and confirming any abatement periods agreed upon. Consultants may also contact you from time to time to check your progress. You, of course, may always contact them for assistance. -2- Ultimately, OSHA does require hazard abatement so that each consultation visit achieves its objective-- effective employee protection. If you fail to eliminate or control identified serious hazards (or an imminent danger) according to the plan and within the limits agreed upon, the situation must be referred from consultation to an OSHA enforcement office for appropriate action. This has occurred only rarely in the past. BENEFITS: Knowledge of your workplace hazards and ways to eliminate them can only improve your own operations-- and the management of your firm. You will get professional advice and assistance without hiring additional staff. The consultant can help you establish or strengthen an employee safety and health program, making safety and health activities routine considerations rather than crisis-oriented responses. Fixed worksites which undergo a comprehensive consultation, correct all identified hazards, and establish an effective safety and health program may receive a certificate exempting them from programmed inspections for one year. The exemption may be limited to smaller employers and to employees covered by federal OSHA. THE ON-SITE CONSULTANTS WILL: --Help you recognize hazards in your workplace. --Suggest general approaches or options for solving a safety and health problem. --Identify kinds of help available if you need further assistance. --Provide you a written report summarizing findings. --Assist you to develop or maintain an effective safety and health program. --Provide training and education for you and your employees. -- Recommend you for a one-year exclusion from OSHA programmed inspections, once program criteria are met. THE ON-SITE CONSULTATIONS WILL NOT: --Issue citations or propose penalties for violations of OSHA standards. --Report possible violations to OSHA enforcement staff. --Guarantee that your workplace will "pass" an OSHA inspection. State OSHA consultation programs, are listed in the state government section of the telephone directory under "Department of Labor and Industry. " -3- U.S. Department of Labor Occupational Safety and Health Administration T*SN 639 Granite Street - 4th Floor Braintree, Massachusetts 02184 Reply to the Attention of: May 30, 1995 FIA request #01-0125-95-100 Thomas A. McKean 0 11 Town of Barnstable R Health Department Cb 367 Main Street >' C Hyannis MA 02601 aD JUN F� 1995 Re: Snow White Sails #109166504 (C6586/020/95) ni Dear Mr. McKean: 2 In response to your request under the Freedom of Information Act for a copy of the referenced investigation report, the following is forwarded: Report #C6586/020/95, Inspection of 04/18/95 (36 pages) 1 . OSHA 1 - Inspection Report (1 page) 2. OSHA 1A - Narrative (with identities deleted) (1 page) . 3. OSHA 1B - Worksheet (with identities deleted) (20 pages) 4. OSHA 2 - Citation u Notification of Penalty and Invoice/Debt Collection Notice (11 pages) 5. OSHA 90 - Referral Report (with identities deleted) (1 page) 6. Letter dated 04/26/95 (1 page) 7. Expedited Informal Settlement Agreement (1 page) Please be advised that the deletion of individual names is based on exemptions 7(C) and 7(D) of the Freedom of Information Act and Departmental Regulations 29 CFR, Parts 70.27(a) (3) and 70.27(a) (14) . Exemption 7(C) permits an agency to withhold information that is contained in investigatory files compiled for law enforcement purposes to the extent that production "could reasonably be expected to constitute an unwarranted invasion of personal privacy." Also, exemption 7(C) was designed to protect the privacy of any individual who is mentioned in government records. Exemption 7(D) protects the disclosure of information which could reasonably be expected to identify individuals who provided data to the government in confidence or under circumstances implying confidentiality. A major purpose of exemption 7(D) is to encourage private citizens to furnish sensitive information to government agencies. If confidentiality were not available, few individuals would come forth to embroil themselves in a controversy by cooperating during investigations. Please note the failure to cite other specific exemptions which may be applicable to a denial of disclosure does not constitute a waiver thereof. U.S. Department of Labor Occupational Safety and Health Administration ME" 639 Granite Street - 4th Floor e4 Braintree, Massachusetts 02184 2 16e Reply to the Attention of: A E The total charge for your request has been waived. i If you regard this as a denial of your request, you are further advised that you have the right to appeal such denial within ninety (90) days from receipt of this response, in accordance with 29 CFR, Part 70.50. Such an appeal must state, in writing, the grounds for appeal including any supporting statements or arguments. The appeal shall be addressed to the Solicitor of Labor, U.S. Department of Labor, 200 Constitution Avenue, N.W. , Washington, D.C. 20210, and such appeal should clearly indicate on the appeal and on the envelope, "FIA APPEAL" Sincerely, Esr �do Area Director I Enclosure 2 Inspection Report U.S. Department of Labor ' Occupational Safely arch Administration MOD Date 1. Reporting ID 2. CSHO ID 3.Optional Report Number 4. Inspection c�� Goa I�I'r tlon, 109166504 S.Related 5 1 5.2 5.3 Activity/ Type Number Satisfied Type Number Satisfied T !♦. Total Activity Type Number Satblki0 Enlriea Satisfied / ❑H ❑S ❑ H ❑S Cl H 7.Previous Activity If Yes., Type Number Has there been previous activity at this establishment) ❑Yes ❑No enter 8. a. ❑ b Establishment Name Change) S Jd J &/W 10. a. ❑ b. S to Address (Sheet. City. State, Z IP 11. City Code 112. County Code Change- S - /� /9 3 13. Mailing Address (II different) (Street. City tale. ZIP) 14. Telephone Number 15. Name of Controlling Corporation. Partner, or Owner 16. Telephone Number (Site) 17. a. rivate Sector c. ❑ State Government } b. ❑ Local Government d. ❑ Federal Agency/Code 19. Was Advance Notice Given? 20.Opening f ence D to ❑ Yes [�'� � / f7 7_-.%�- 21. Mark "X" in one box 22.Primary SIC 23. Secondary SIC afety ❑ Health / a. Guide 24. Mark "X" in one box 2S. Inspection Clasalflcallon (Mark all that apply) Unprogrammed a. Safety Planning Guide: Q'Ma ufacturing [ Construction ❑Maritime a. ❑ Ayeident e. ❑ Variance b Health Planning Guide: ❑Manufacturing ❑Construction ❑Maritime b. Lrd/Complaint f. ❑ Follow-up c. ❑ Referral g. ❑ Unprogrammed c. ❑Local Emphasis Program (specify) d. ❑ Monitoring Related PrograMmed d. ❑National Emphasis Program (specify) h. 101anned i. ❑ Programmed Related e. ❑Migrant Farmworker Camp 26. Number of Employees 27. Number of Employees 28.Number of Employees 29. a. ❑Un n 30. a. ❑Employee Exercised Employed in Establishment Covered by Inspection Controlled by Employer EmployeeWalkarou Privilege? b. Non- 1 -., , union 3 w� - Copy below the OSHA-200 Log entries for the most current gomplete year. 133. LWDI Rate 31. Year: 32. Onata Not Available Occupational Injury Cases Occupational Illness Cases (7) (�) (2) (3) (4) (5) (6)- (a) (b) (c) (d) (e) (f) (g) (8) (9) (10) (11) (12) (13) - 35. Scope a ❑Comprehensive b artial c. ❑Records Only d. ❑No 36. Number of Days Site Visited (Mark "X" in one box) Inspection Inspection Inspection Inspection a 37. Anticipatory Warrant/ 38. Date of Denial 39. Date Re-Entered 40. Date Re-Denied 141. Date Re-Entered Subpoena Served ❑ Yes 42. Optional Information Type ID Value Type ID Value 43. Tota1 Entries 44. 45. If no inspection conducted. mark "X" in one box 46. Closing a ❑ Close a. ❑ Establishment Not Found d. ❑Ten or Fewer Employees g. ❑Worksite Exempt Through Conference Date b. ❑ No Voluntary Program (On Site) Citations b• ❑ Employer Out of Business e. ❑Denied Entry h. ❑Non-Ex Issued Tess Consultation in Progress c. Process To Be 1. ❑SIC Not on i. ❑Other , /// f�/G� spec Not Active Planning Guide ` Narrative U.S. Department of Labor Occupational Sa!ety and Heath Administrationp 1. Estabdsfvnent N we } S. InSpeodon NumberD / 9. Type of Legal 4. Type ness or Plant S. Additional Cltetlon Malllnp Addresses (1) Name (2) Name Attn: Attn: Street Address Street Address i City State Zjp City State Zp d. Names and Addresses of AU C 7. Authorized Representatives of Employees: yy Organized Employee Groups: M A Namer ❑ Name Tele. No. Y ❑ Y Local No. T o. Organization T Address Home Address Zip Code Zip Code Name ❑ Name Tole. No. Y ❑ Y Local No. Tale. No. Organization Title Address Home A ress Zip Code Zip Code I. Employer Represent. I m Credentials Presented C- Closing Cont. W 9.Other Persons Contacted: ath►es Contacted: O- Opening Cont. M- Other Mgmt. Office. A Title OA+�c�c_ Function ' Name, Occ�- ❑ gallon 8 Affiliation 1 O Y ❑ Home Address Tele. No. Y r ❑ Zip Code Y f ❑ Name, Occupation&Affiliation Y 10.Coverege information Home Address Tele. No. i Zip Code 11.Date&Time of Entry: 12. Date&Time Walkaround Began: 13. Date&Tme Closing Conference Began: 14. Date&Time of E)dt: (1) (2) 1S.Follow-up Inspection Recommended: Yes ❑ No 0 Reason: 1S.CSHO Signal Dat . 17.Accompanied by: • / `1 f Worksheet U.S. DepartiAnt of Labor Occupational Safety and Health Administration <, 10 i. 4. Date/Time S. Instances on Page eQ W�?, �9 (a. b, `. Violation 7.Citation No.IS. Item No. 19.On SIte4 10.Standard a t Violated 11.No. Exposed 12. No. Instances 113. REC Viola ❑ /V• /3 , V 14. Abatement Period Trk7 16.Action Date Type 16. SAVE Manual 17. SAVE ID(Pg/Item) 18. Ref. No. ,g6 Uil ❑C ❑ M � • y — 19.AVD/Variab lion: oe 20. Instan ription (a. Hazards-Operation/Condition-Accident; b. Equipment; c. Location; d. Injury/Illness; and e. Measurements) - Cont'd -- 21. Photo Y a. Occupation (8 Employer) b. No. c. Total Duration d. Frequency e. Exposed Employee—Name, Address 8 Telephone _C(Aa FL W W ed Cont'd 23. Employer Knowledge: 24. Comments (Employer, Employee, Closing Conference): Cont'd L 25. Other Employer Information 26. Classif.: a. Failure to te') b. Serious H r D7 c. K owl.9 d. Syr O? e. 9 t. 27. Probability a.No. b. Freq. c. Prox.to d. Stress e. Otner f. Subtotal g. Prob.O h. Severity 0 i. Total i. i/2 Rating Employees. of ExD Danger Factors Factors 2- Y��N A-8.6,—I — 28. Penalty a. Prob. of Injury/Illness r vity-Based c. Times Repeated/ d.Adjustment Factors e. Proposed or Penalty Degree of Willful Adjusted Penalty No. Cal. Days Uncorr. 1) Size 2) Good Faith3) History 4) Total 67V G G C; Case File Page Worksheet U.S. Departmrit-of Labor Occupational Safety and Health Administration IL Two of T. Citation No Ill. Item No. 9.on site? 10.Standard Allegedly Vid led /t Violation S 4_ % 11.No. Exnn—d lit No. Instances 113. REC 14. Abatement Period Trk? 1 15.Action Date Type 16. SAVE Manual 11?. SAVE ID Mft�ltem) 14. Ref. No. It. AVD/Vanatln �| 21. Photo / a. O.�tion(& Emp"r)/ b. No. c. al Duration d. Fjq�uency e. ExposedErnployee ' Name, Address&Telephone JC 24. Comments (Employer, Employee, Closing Conference): Cont d 25. Other Employer Information 28. Penalty a. Prob. of Injury/Illness rivity-Based c. Times Repeated/ d. Adjustment Factors e. Proposed or e7vPenalty Degree of Willful No. Cal. Days uncorr- Adjusted Penalty 1) Size 1 2) Good Faith 3)History 4)Total Case File Page � ' � ~ Worksheet U.S. Department of Labor Is 1! occupational Safety and Health Adirninistration �T I -Is 1 0 1 0) / Z) le— I I 114.AbatemenAPeriod Trk? 11S. Action Date Type 18. SAVE Manual 11?. SAVE 10 ft/ltem) Air _4 Exf- 17. SAVE (P to 20. Instance Description�(a.�Iazar�-Opela tion/Condit ion-Accident; b- E u*lPrnent; c. Location; d. Injury/Illness; and e. Measurements) 21. Photo a. Occupation (& Employer) b. No. c. Total Duration d. Frequency e. Exposed Employee—Name, Address&Telephone 00 23. Employer Knowledge: Cont'd 24. Comments (Employer. Employee, C40sing Conference): | -- ---------....— .... ��--------'------------------ 2S. Other Employer Information 27. Probability a.No. b. Freq. C. P ox,10 d. Stress e. Other f. Subtotal Prot).0 h. Severity a i Total 1. i/2 Rating Employees of Exp Ganger Fa Factors 23. Penalty a. Prob. of Injury!Illness r vity-Based c. Times Repeated/ d. Adjustment Factors e. Proposed or Penalty Degree of Willful No. Cal. Days Uncor . 1) Size 2) G�FaiT 3) History 4) Total Adjusted Penally Worksheet U.S. Department of Labor Occupational Safety and Health Administration I.buW;*N! 2. CSH0 10 3. OptionalNe. Date/ S. Instances on Page jr (a. b, ration No. 8, Item No. 9.On Sites 10.Standard Allegedly Violaled DaleIr Instances a a. b =afion 11.No. Exposed 12. No. Instances 13. REC -3 0 1rf 16 I 2�'D em 14. Abatement Period Trill! Is. Action Date Type lie. SAVE 'Janual 17.*SAVE ID (Pg/item) 16. Ref. No. 1 0 M 1,40 ;GI El C C] m 2—_ it. AVD/Vanabl (mation: Z' 20. Instance Description (a. Hazards-Operation/Condition-Accident: b. Equipment, c. Location: d. Injury/Illness: and e. Measurements) o, 00 '0 • 37 A nt'd 21. Photo Y "I000lo!�i,Pwr J _7 a. Occupation (& Employer) No. c. Total Duration d. Frequency e. Exposed Employee—Name, Address&Telephone I Cont'd 23. Employer Knowledge: 24. Comments (Employer. Employee. Closing Conference): 25. Other Employer Information Cont'd 26. Classif.: a- Failure to? b. Serious M or tr c Know or M.) d. S I ;1r I Y I 1 01/1 1"J 27. Probability a.No.I b. Freq. c. Prox.to d. Stress e Other f. Subtotal g Prob.0-T. Severity 0 i Total Rating Emoloyees of Exo Danger Factors Factors i/2 -----------f 211111. Penalty a. Prob. of Injury/illness b. Gravity-Based c. Times Repeated/ d. Adjustment Factors e. Proposed or Penalty Degree of Willful No. Cal. Days Uncorr- 1)Size 2)Good Faith 3) History4) Total Adjusted Penalty Worksheet ' U.S. DepartMInt of Labor CCU• Occupational Safety and Health Administration 1>,btspec" I.CSHO 10 2.Optional Oaten p S. Instances on Page t.Typetio+ T. Citation No. A. Item No. >l.On Site? 10.Standard Allegedly VIg1a ed 11 No YYwOltaa s �C` 12. No. tnstances 12. REC 11. Abatement Period Trk? IS.—Action Gate Type 16. S�AVE�' nual . 17. SAVE 10(Pg/Item &U DGI O C Q M ) ta. Re�o It. AVO/Variable lion: 20. Instance Description (a. Hazards-Operation/Condition-Accident; b. Equipment; C. Location; d. Injury/Illness; and e. Measurements) �--- - -- -- -- -----�._ .- I'd 21. PhotoAwe a. Occupation (S Employer) No. C. Total Duration d. Frequency e. Exposed Employee—Name. Address&Telephone WW 23. Employer Knowledge: 24.Cormtents (Employer. Employee, posing Conference): 25 Other E Cont'd mployer Information I i a. Failure t0 tB 0. Ser H or E r C. Knowl. d. S of e f. 2e. Gassit.: � � 27. Probability a.No. t b FreQ c. Pro+. to d. Stress e. Omer f. Subtotal g PrOb.O h. Seventy O i. Total I. i/2 Rating Employees of Exo. Ganger Factors Factor a� — �- Gr 2A. Penalty a. Prob. of Injury/Illness b avity-Based c. Times Repeated/ d. justment Factors a Proposed Adjusted Penalt or Penalty Degree of Willful No. Cal. Days Uncorr. 1)Size 2)Good Faith 3) History l)Total y O-9 u 40 j Case File Page Worksheet U.S. Departrqgnt of Labor Occupational safety annrd Health Administration t N 4 CSHO ID 3.Optional R Date/T S. Instances on Page �g (ab /) Standard Akpadly ! O• / 11.No..ET tZ"No. tnstanosa 13.'REC 14.Abatement Period Trill IL Action Date T C.7 ype 16.,S-,AVE ;81 17. SAVEEID ftntem) I& Ref. No. tiD.AVD/Variade lion: C ❑ M e�— 20. Instance Description a. Hazards-Operation/Condition-Accident; (-- - Aeration/Condition-Accident b. Equipment c. Location; d. Injury/Illness; and a Measurements) 4_ .3 7" _ _ Al nt'd _ -- ---- — 21. Photo Y Ay a. Occupation(& Employer) No. c. Total Duration d. Frequency e. Exposed Employee—Name, Address 3 Telephone 00 Ex W W 23. Employer Knowledge: Cont'd 24.Comments (Employer, Employee, Closing Conference): 25. Other Employer Information Coll k t 26. Classif.: a. Failure to bate? b. Serious H or D?C. Know.? d. S or 0? e f W or 27. Probability a. No. b. Frill . C. Prox.to d. Stress e. Other 1. Subtotal Rating Er^ployees of Exp. Danger Factors Factors g Prob.0 h. Severity0 i. Total j. i/2 26. Penalty a. Prob. of Injury/Illness Gr vity-Based c. Times Re eated/ / or P d. A ustment Factors a Proposed No. Cal. Days Unco Penalty Degree of Willful 1) Size 2)Good Adjusted Penalty Faith 3) History 4) Total Case File Page of Worksheet U.S. Department of Labor �(�+ Occupational Safety and Health Administration all.CSF6D� � 3.'Pptionat RepW/No. 4. Date/Txr�e Instances on Page 7� 7� (a. b. /) T.Citation No. 8. Item No. 8.On Site? 10.Standard Allegedly V 11.No. Exposed 12. No. Instances 113. REC 14.Abatement Period Trk? I& Action Date Type 16. SAVE Manual. 1T. SAVE ID(Pg/Item) 18. Ref. No. A.AVD/Va' formation: r /tea 00, ty 20. Instance Description (a. Hazards-Operation/Congitiiont�Accident; b. Equipment; C. Location; d. Injury/Illness: and e. Measurements) — Cont'd 21. Photo a. Occupation (& Employer) b. No. c. Total Duration d. Fr uency e. Exposed Employee—Name. Address&Telephone -- O N p W w N Cont'd 23. Employer Knowledge: 24. Comments (Employer, Employee, Closing Conference): 2S. Other Employer Information Cont'd } 26.Classif.: a. Failure to te? b. Se r' or D? c. Kno .? d. S or cp a ft? f _S / 27. Probability a.No. b. Frei( c Prnger Factors Factors Ox.to d. Stress a Other f. Subtotal g. Prob.O n. Severity O i. Total j, i/2 Rating Employees of Exp. Da 28. Penalty a- Prot.of Injury/Illness b. Gravity-Based c. Times Repeated/ d. Adjustment Factors 'e. Proposed or Penalty Degree of Willful Adjusted Penalty No. Cal. Days Uncorr. 1) Size 2) Good Faith 3) History 4) Total Case File Page TOP oc-- --- Cp 'Y. -Oowrrnrfl lW"Oflbc 100—312-37"1979 Worksheet U.S. Department of Labor !!,' Occupational Safety and Health Administration ``-� /.Inspection r 2. CSHO 10 S.optional Z AP A-- 01 91 Ilk ��111101 /• Oate/Time S. Instances On Page !.Tppe of I?. Citation No. 8. Item !.On Site) Allegedlyla, b. /) Violatbn 10.Standard Y l • 11.No. Exposed 12. No. Instances 12. REC 11.Aba,,,,,,.tement Period Trk� 1S. Action pate Type 18. SAVE Manual �— � �• n- 17. SAVE ID (Pg/Item) 18. Ref. No 19. AVD/Varied formation: ❑C DM 71 20. ►nstance Description (a. Hazards-operation/ ition-Accident; b. Equipment; q pment; C. Location; d. Injury/Illness; and e. Measurements) 41 — -- • Conrd - --- -- 21. Photo -------- a. Occupation(8 Employer) b. No. c. Total Duration d. Fr uency e. Exposed Employee—Name, Address 6 Telephone , - W W 23. Employer Knowledge: , Coll 21. Comrnents (Employer, Employee. Closing Conference): 25. Other Employer Information Col t_ 26. CSassif.: a. Failure tO te) b. Ser Or 0" C. K ? d. S or Cr 27. Probability a. NO. b. Fr c. Pro■.to d Stress . Rating Employees o1 E.O. Danger Fact e Other ors Factors I. Subtotal g PrOb.O h. Severity O i. Total 28. Penalty a. Prob. of Injury/Illness b. Gravity-Based C. Times Repeated/ or rr., Penalty Degree of Willful d. Adjustment Factors e. Proposed No. Cal. Days Unco Adjusted Penalty //t) Size 2)Good Faith 3) History a) Total Case File Page I TOP pf"Ofko: I —712-V"1979 Worksheet U.S. Department of Labor �) Occupational Safety and Health Administration / 1.Inspection N 2.CSHO iD.� 3. Optional R �o. 440ale/ G� S. Instances an Page 7� (a. b. /) c� g,Type of 7. Citatan No. 6. Item No. !.On Site? 10.Standard Allege1.No. Exposed 12. No. Instances 13 REglal!on 3o Z14. Abatement Period Trk) 1S. Action Date Type 16. SAVE Manual �-AVE ID (Pg/Item) 16. Ref. No. G 1 ❑C �- 10.AVD/Vanabl formation: 20. Instance Description (a. Hazards Operation/ ition-Accident; b. Equipment; c. Location; d. Injury/Illness; and e. Measurements) /j s -- - - -- Cont'd 21. Plato — Y a. Occupation (8 Employer) b. No. c. Total Duration- d. FrIluency e. Exposed Employee—Name, Address 3 Telephone �8 W W Cont'd 23. Employer Knowledge: 24. Comrnents (Employer, Employee, Closing Conference): A. _. -__.__--- _ I Cont'd 25. Other Employer Information N. Oassif.: a. failure to bates b. Ser or D' c. K .? d. S or O' e./ir t. 27. Probability I a. No. b. Fr . c. Pros.to d. Stress J e. Other r Subtotal q. Prob.O h. Seventy O i. Total 1. i2 Rating Employees of Exp. Danger Factors Factors 26. Penalty a. Prob. of Injury/Illness avity-Based c. Times Repeated/ d. nt F justmeactors e. Proposed or Penalty Degree of Willful Adjusted Penalty No. Cal. Days Uncor. y t)Size 2)Good Faith 3) History 4) Total O / svo -- �o �s o / y�� 7 S - - TOP --V.S.bowmwh PrWng Coke: IOW—312-37SM197,9 4 Worksheet U.S. Department of Labor ((�, Occupational Safety and Health Administration ?.kKpection N r 2. CSHO 10 2.Optional 11�No. 4. Date/Time p d S. Instances on Page �.T W 7� (a. b. /) IIPet� 7. Cimarron No. 8. Item No. f1.On Sited 10.Standard Allegedly Vidal Vbl / 6 D 11.No. Exposed 12. No. Instances 12. REC /O► .3u3 14. Abatement Period Trk) 13. Action Date Type 16. SAVE Manual 17. SAVE ID P /stem �. ( g ) 10. Rel. No. GI OC DM oth 7. k/ 19. AVD/Variabl formation: 20. Instance Description (a. Hazards-Operation/Co ition-Accident; b. Equipment; C. Location; d. Injury/illness; and e. Measurements) — _ — - -- _ nt -- -- _ 1 Photo --- a. Occupation (& Employer) b. No. c. Total Duration d. Fr uenc Exposed Y e. posed Employee—Name. Address&Telepfmone m ac WW N 22. Employer Knowledge: Cont'd 24. Comments(Employer, Employee, Closing Conference): 25. Other Employer Information Cont'd 26. Classif.: a. failure to te) b. Set or 0'c. K 9 d. S or Cr 1 27. Probability a.No. b. Fr C. Prox.to d. Stress J e. Other f. Subtotal Rating Employees of Exp. Danger Factors Factors g Prob.0 h. Severity o i. Total 20. Penalty a. Prob. of Injury/Illness b. Gravity-Erased c. Times Repeated/ d. Adjustment Factors or Penalty Degree of Willful e. Proposed No. Cal. Days Uncorr. Adjusted Penalty 1) Size 2)Good Faith 3) History a) Total TOP ate. ----- U.S.C.owrcwm PAntlnq Ofte: !992—3t2.776,'6!979 Worksheet U.S. Department of Labor Occupational Safety and Health Administration 1.Ir>spact' N Z. CSHO 10 3.Optional Reqort No. 1. Date/Time /C S. Instances on Page ..QSL6�a'-dJ (a. b. n •.Typed T. Citation No S. Item No. 8.On Sile? 10.Standard Allegedly Violated 11.No. Ex 1Z. No. Instances 113. REC VViioollaa ❑ 3 c < / 14. Abatement Period Trk? 15. Action Date Type it$. SAVE Manual 1?. SAVE 10 (Pg/Item) 18. Ref. NO. N=i RVE�GI ❑C ❑ M 10. AVO/Vasa In i 20. Instance ion(a. Hazards-Operation/Condition-Accident; b- Equipment; c. location; d. Injury/Illness; and e. Measurements) G Cont'd --- — -- -- ---- -- ------ �------- — - ^_. � 21. Photo 2 Y a. Occupation (6 Employer) b. No. c. at Duratior>, d. F uency e. Exposed Employee—Name, Address&Telephone WW ' 23. Employer Knowledge: 24. Comments (Employer. Employee, Closing Conference): Cont'd ZS. Other Employer Information 26. Classif.. a. Failure t0 ADato) b. or Cr I c. Knowt.? o. S D' a 27. Probability a No. b. Freq. c. Pro■.to a. Strew a Other t Subrotat g. Prob.0 h. Severity 0 i. Total t. 1/2 Rating Employees of E:p. Danger Factors Factors 26. Penalty a. Prob- of Injury/Illness b. Gravity-Based c. Times Repeated/ d. Adjustment Factors e. Proposed or Penalty Degree of Willful No. Cal. Days Uncorr. Adjusted Penalty t) Size 2)Good Faith 3)History 4) Total Case F!e Paae Worksheet U.S. S. Department of Labor Occupational Safety and Health Administration hspeC N 2. CSHO to S.Optional No. 4. Date/Time S. Instances on Page /D J (a, b. /) `.Viotatlo 1 B T. Citation No. 8. It m No. 8,On Site? 10.S��a Allegedly bled 11.No. Exposed tZ- No. Instances 113. REC Via L�, 14.Abatement Period Trk? 15. Action Dale Type 18. SAVE Manual 17. SAVE ID(Pg/Item) /8. Rel. No. LNSGI ❑C ❑ M / �• �- 18.AVO/Variab 1 rrn 'on12 — 20. Instance crj ion (a. Hazards-Operation/Condition-Accident; b. Equipment; c. Location; d. Injury/Illness: and e. Measurements) _ _ — - ----- - --- -- ----_� Cont'd - - 21. PhotO G" Y a. Occupation (& Employer) b. No. c. al Duration d. F uency e. Exposed Employee—Name, Address&Telephone m 00 n0 Ex ww Cont'd 23. Employer Knowledge: 24. Comments (Employer, Employee, Closing Conference): i — Cont'd 2S. Other Employer Information 26. Classif.: a. Failure to Abate? b. Ser' s H or co c. Knowl? d. S 0? e. q? I W 27. Probability a.No. b. Freq. c Prox.to d. Stress e. Other f. Subtotal g. Prob.0 h. Severity 0 i. Totai j. 1/2 . Rating Employees of Exp. Danger Factors Factors 28. Penalty a. Prob. of Injury/Illness b. Gravity-Based c. Times Repeated/ d. Adjustment Factors e. Proposed or Penalty Degree of Willful Adjusted Penalty No. Cal. Days Uncorr. 1) Size 2) Good Faith 3) History 4) Total JA— Case File Paoe Worksheet U.S. Department of Labor Occupational Safety and Health Administration / l: I IS R No.14. S.Date/Time . Instances on Page r��/ (a. b, /) S,:Type f O 7. ' lion NOT. ue�No. 8.On Site? 16.Standard Mlegeayyv�,� 1/.No. Exposed 12. No. Instances 113. REC �a 1 7 o. 14 14.Abatement Prificid Trk? 15. Action Date Type 18. SAVE Manual• 17. SAVE 10 (Pg/Item) 18. Ref. No. lJ RIG ❑C ❑ M 19.AVD/Variable In lion: 20. Instance Description (a. Hazards-Operation/Condition-Accident: b. Equipment: a Location; d. Injury/Illness; and e. Measurements) --- ---.-- - ----.......... Cont'd 21. Photo Y a. Occupation (& Employer) b. No. c. Total Duratioq d. Frequency e. Exposed Employee—Name. Address 8 Telephone m a� w to !V Cont'd 23. Employer Knowledge: 24. Comments (Employer. Employee, Closing Conference): � I Cont'd 2S. Other Employer Information t 26. Classif'.: a. Failuregbatel I b. Serplis H or Cr I c. n w1.9 d. S y 07 27. Probability a.No. b. Freq. c. Pfox. to d. Stress e. Other 1. Subtotal g. Prop.O h. Severity O i. Tctal t. 1/2 Rating Employees of Exp. Danger Factors Factors 28. Penalty a. Prob. of Injury/Illness b. Gravity-Based c. Times Repeated/ d. Adjustment Factors e. Proposed or Penalty Degree of Willful Adjusted Penalty No. Cal. Days Uncorr. 1)Size 2)Good Faith 3) History 4) Total Case File Pace Worksheet U.S. Department of labor e Occupational Safety and Health Administration 1.Inspection N Z. CSHO ID�� S.Optiortw IIo. 1. Date/Time E12NI, stances on Page S.Type of O 7. Citation No. S. Item o. S.On Site? 10.Standard V' t 11.No. Exposed . Instances 13. REC valatlort 0 .y « MIL (L 14. Abatement nod Trk? 15. Action Oate Type 16. SAVE Manual 17. SAVE 10(Pg/Item) 1!. Ref. No. Cl D c I M ��8, 1t.AVO/VanaDl formation: 20. Instance Description(a. Hazards-Operation/ ition-Accident; b. Equipment; c. Location; d. Injury/Illness; and e. Measurements) Cont'd 21. Photo y a. Occupation (8 Ernployer) b. No. c. Total Duration d. Fr uency e. Exposed Employee—Name. Address&Telephone Ex$ W uJ t 23. Employer Knowledge: 24. Comments (Employer. Employee. nosing Conference): t- -- I Cont'd 26. Other Employer Information 26. Classif.: a. FadureVbatel b. Se r or 00 c. K .? d. $or O? e./i? t. ? 27. Probability a.No. b. Frei( c. Pro: to d. stress •! e. Other I. Subtotal 0. Prob.0 h. Seventy 0 �. Total 1. i2 Rating Errwloyees of Exp. Danger Factors Factors U 23. Penalty a. Prob. of Injury/Illness b. Gravity-Based c. Times Repeated/ d. Adjustment Factors e. Proposed or Penalty Degree of Willful Adjusted Penalty No. Cal. Days Uncorr. 1) Size 2)Good Faith 3) History d) Total -- - - TOP V.S.Gmwmmm Pr"deer. 1992.—312-P"1979 Worksheet U.S. Department of Labor Occupational Safety and Health Administration 1.MapectioR 2. CS 1 2.Op e S. Instances on Page GG � /r A r� (a. b. /) t•.TYPe of O 7.Ci anon N0. S. Item g,O Site? t0.Standard Anegedly Violated 11.No. Exposed 12. No. Instances 13. REC fdation o. -o( (► 1,11I. Abatement iod TO') 15. Action Dete Type 16. SAVE Manual 17. SAVE ID (Pg/Item) 16. Ref. No. ETIGI ❑C ❑ M 67i . � 16. AVD/Vanable Inf ation: - 20. Instance Description (a. Hazards-Operation/Condition-Accident; b. Equipment; c. location; d. Injury/Illness; and e. Measurements) 14 Cont'd 21. Photo Y a. Occupation (8 Employer) b. No. c. Total Duration, d. Frequency e. Exposed Employee—Name. Address&Telephone m E 2xi lV Coni'd 23. Employer Knowledge: 24. Convnents (Employer, Employee. Closing Conference): 1. Cont'd 25. Other Employer Information 26. Classif.: a. Failure t te') D. ser;p M or D'r c. n W 7 0 S qr o'r a of 1. y 27. Probability a.No. 0. Frep. e. Dan to d. Stress e. Clow f. Subtotal g Prob.O n. Seventy 0 Total Rating Employees of Exo. Danger Factors Factors !!,, Vl 26. Penalty a. Prob. of Injury/Illness b. Gravity-Based c- Times Repeated/ d. Adjustment Factors e. Proposed or Penalty Degree of Willful Adjusted Penalty No. Cal. Days Uncorr. 1)Size 2)Good Faith 3) History C) Total / o - 6 a ,, c:�'s 1 e' a Case File Page ? U.S. Department of Labor; Occupational Safety and Health An,..mistration • Ito Boston Area Office South 639 Granite Street-4th floorBraimree. MA 02184 Phone: (617)565-6924 FAX: (617)5M-6923 Citation and Notification of Penalty To: Inspection Number: 109166504 Snow White Sails Inspection Date(s): 04/18/95 - 04/18/95 and its successors Issuance Date: 04/26/95 230 Falmouth Road Hyannis, MA 02601 Inspection Site: Thr vfolarzon(s descry ut G1ftatox 230 Falmouth Road and 1Yo ky fs (anj`alleged Hyannis, MA 02601 to have occurred og or about tht da''W the inspection tivas �adc unless othenvrse Indtccttt. wkhtn the descrlptlon giyat befaw 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 Citation 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 3000) which outlines your rights and responsibilities and which should be read in conjunction with this form. Issuance of this Citation does not constitute a finding that a violation of the Act has occu TW 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 Conferenee - 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. Citation and Notification of Penalty Page 1 of 9 OSHA-2(Rev. 6/93) t� C`1 If you decide to request an informal conference,please complete, remove and post the page 3 Notice to Employees next to this Citation and Notification of Penalty as soon as the time, date,and place of the informal conferem 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.ty 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 thaayou intend to contest Me dtadou(s) and/or p within 15 worNM days afterrwdijLh dtadon(s) and the on QW&III(les) me a fliml order of the Occupational We and Health Review CommlWon and may not be reviewed by an court or ageng►. 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 or money order 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 i 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 violations o atrons which you do not contest, you should notify the U.S. � Department of Labor Area Office promptly by letter that you have taken appropriate corrective action within the time frame set forth on this Citation. Please inform the Area Office in writing of the abatement steps you have taken and of their dates, together with adequate supporting documentation, e.g., drawings or photographs of corrected conditions, purchase/work orders related to abatement actions, air sampling results, etc. 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 3000)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. Citation and Notification of Penalty Page 2 of 9 OSHA_2(Rev. 6M) . A U.S. Department of Labor Occupational Safety and Health Administration A4 S NOTICE TO EMP LOYEES EES OF INFO RMAL CONFERENCE An informal conference has been scheduled with OSHA,to discuss the citation(s) issued on 04/26/95. The conference will be held at the OSHA office located at Boston Area Office South, 639 Granite Street-4th floor, Braintree, MA, 02184 on at i Employees and/or representatives of employees have a right to attend an informal conference. Citation and Notification of Penalty Page 3 of 9 OSHA-2(Rev. 6/93) r ---- ------- 1 U.S. Department of Labor Inspection Number. 109166504 Occupational Safety and Health Administradoo Inspection Dates: 04/18/95 -04/18/95 I[ssuance Date- Citation and Notification of Penalty 04n6/95 T'Y' Company Name: Snow White Sails Impection Site: 230 Falmouth Road, Hyannis, MA 02601 Citation i Item i Type of Violation: Serious 29 CFR 1910.151(c): Where employees were exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body were not provided within the work area for immediate emergency use: Receiving Area: Employees required to handle corrosives were not provided with an adequate eye wash station. t Win• ~ .:,'? +•�;f•}-: <: �p ��'•�a{-':ih� .�•�ppt• �/jf+ f.;+ti.a:�?:`}:�Jin::'.'i t}•{`}{.+Y;�.i:lt �~'v\ n.. ...'� h t\<��\tt�:�ti�{ni::tih 4i.�.}�<pv�f�C•£�`;��`4\'t�t�'��,-`• t-i��:i�a`•+t+{, '. •. �Ft C�v�- t a .�'.A7:h{p j.Q^:• .. a \ll{tVt`�iA•� ttit~:,`tWK•'{~N.\�t'CC0.�hh�la•'ti't t ...•'•:::.v.:.]�~� +lL$�v Citation 1 Item 2 Type of Violation: Serious 4 29 CFR 1910.212(axl): Machine guarding was not provided to protect operator(s) and other employees from hazard(s) created by moving parts: Receiving Area: The crushing hazards created by the moving platform of the hydraulic lift were not'guarded. t y t. .:M'K{+'•}:•:`\'4- {:;-'.- !Ctt{.y'.tC?:'(!{{?::\p.}ri-:Jv+ '+`:\.;ark~: :t\ L .:. -'�'��nt}~,.;...tv".t+''s;'i{_o<:tc,ca<4.`•'�}:Sf.-:?:.:..:•.}'+t :�_ �'••.slo.+...`.:t <t�' .;}�.y;}>•?`...•':``::}',fi.:x}�;?-:.i:�':`tfi '^'•pC:.,q:\S:Gt.}•.�•.:<p.,. Vt.}:ti'. .`'�"•• �"�.:t'Y}.•-{`'t:t::.. :� ;c} :.{•r..?:: .._fl•+w.rtin:Y••:: 6:tC'.`::J�}•.n����-tc`:.?.`t ",Y�,c�•�..3?:t•A �/ ..�~A".�t\{ -+?v. .+.tr... .. tan t... n..:iv<i:.t'+'�,�•.{�\ `�.� { .t � .t:\ti� +tr.:• ttv..' ,• t} .. ? •.,y" }}j}.. :.:vn vtr ... {LC;Ot.• ..a tt,�•M�Xvfiacw.{u.:iacr�. .. .NARka:a;a.JL2;-ti2wc:, :a\•.{,w.t<Zttt,•}� *Stwc.t{Gf"'JRY. . l See pages h through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 4 of 9 OSHA-2 (Rev. 6193) U.S. Department of Labor Inspection Number. 109166504 t Occupational Safety and Heath Administration. Inspection Dates: 04/18/95 -04/18/95 Issuance Date: 04MM Citation and Nodflcadon of Penalty Company Name: Snow White Sails Inspection Site: 230 Falmouth Road, Hyannis, MA 02601 Citation 1 Item 3 Type of Violation: Serious 29 CFR 1910.219(d)(1): Pulley(s)with part(s)seven feet or less from the floor or work platform were not guarded in accordance with the requirements specified at 29 CFR 1910.219(m) & (o): Lower Finish Department: 1) The belt pulleys on the Saxmeyer typing machines were not guarded. 2) The belt pulleys on the left hand side of the American Laundry sheet ironer were not adequately guarded. i .}�n•.o•��, ''�,t•,.;'• •�..,� }i�v�g'.�yC��'�,,.1.%s`c"\�`M A yi. '� , . Citation 1 Item 4 Type of Violation: Serious 29 CFR 1910.219(f)(1): Gear(s) were not guarded by a complete enclosure or by one of the methods specified in 29 CFR 1910.219(f)(lxii) and (f)(IXhi): Lower Finish Area: The gears on the left hand side of the American Laundry machinery sheet ironer were not adequately guarded. iA }'�... .. �:.••:.�r..:nvn.w:::t..•,+.}.. v `:4v� :M1�l+.' ,\•, .':}. ;h..:•::??}�:{^: }.,:}:, .v{m :�v\ ::.A•: $:?c�\,:-}.^"•F._.+,.) •..r`. ,}}.h�•... :S;'.:w:.._;.v;,-;.}{:: ;,.}•:.X'{.:,.:o}Si:.{i':n:R.{::i:.av:.\}J9'?"':: ::n'•'2.•., �%}$a`.Gr.: n..\%• .........:.:...n. O. ..:..:•. .' }::?::%h:•{}':iin}}:'F.}^:•:{•;.:}:Y:t.%•}i:f?n:::%':}'i\':$:-`.i::.:ii nZ:�i::i M•� �F:'.14:Vx •.n .A�?:{-i??'•:}{!}:,•.:'v•: %isii:%iv?iiiiii\y}:}i>..}:}:.v}'.::iti:^:}ii:?iii:6•:':-.)\.:4:n:+:•::::;nni.:.}}}}...... :•.J%,{::• �/a�� F'+' •:v:}•v:}:::.'::L:v:{w:.. :,' :i.. :r:X••{. ... . .x,,..�c•:tiv}:.x;;C.. ids:+:if,• `+:` ::: d •X':.'•�}: See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 5 of 9 OSHA-2(Rev. 6/93) U.S. Department of Labor Inspection Number. 109166NM Occupational Safety and Health Administra* Inspection Data: 04/18/95 .04/18/93 Citation and Notification of Penal Issuance Date: 04n6/9s ty Company Name: Snow White Sails Inspection Site: 230 Falmouth Road, Hyannis, MA 02601 Citation 1 Item 5 Type of violation: Serious 29 CFR 1910.219(f)(3): Sprocket wheels and chains which were seven feet or less above floors or platforms were not enclosed: Lower Finish Area: 1) The chains and sprockets on the right hand side of the American Laundry machinery sheet ironer were not guarded. 2) The chains and sprockets on the right hand side of the Chicago Jet fold folding machine were not guarded. 3) The chains and sprockets on the right hand side of the Chicago Jet fold folding machine were not guarded. •.}}:or•Yrh. ,}k::v �: : E- ..�a}.N: �e}::•�.. •<a•5.;.:::.•�:,}r >2;C;..^"{.`.±c;:;:trSR^.:;- •4:v.:.:v R:':�}r•{}v:.'.."iu`>.S k„ � ..��. - .:yv:x..'•: :u{xv:f..;! ���i}?2'�i:;t: v.�:i'r.•A{: : -}:{:r?'sx'�..�'.?4ry.. .4.:::ti{�:w�h};C4`.? ax2"':•. '^�'<:�'•'}...a .s'sr{;::.' '�::: :: ��-"- }},t.:.,;:;{:::}:a-r ::�'�:: ... 4.: C?'<�/�r\ �' {�?�:.�t-.�;'.y •.Y.'xi�}�..:" ' '`n1••:f."«+ 2:-:>.;}}:..... {o. �fk3^ti .�;x}�` .;. :\s 2;F � �.\.. }�:''k :.{�'•"+'.•r..-�.,0{r4:.n•<.}vt:i?iX'�:^iF. Y i..": ��i:�l. }�".N.}:4.{`}�-: c`a." �\"3::•}w.•}{v.\ :`c::`•:. .fx.RS.v;•F:.:.;:.v.:�.f:?...�::• a�.4' ::: n � _� a.<� 3:'.'K.:}"}?:�hn:..v:�� .:.S S'nG:vi.M?i`i3'.4`?:ii::i\ 1::3?$,1 �•y! .:}iab..:fca � �o�':}Y�r�}.i•'•"S:':a"��-: :}�}:::�wY` `ry:.:'•:},f/,!�}��x�{a..:,-:,�. .�..�.� ��' Y r ..............::..2,;. 3x fuii:.}'s}ia..Nao2c�i`oC:'-'w�:}.Jiw�.t'•�'�•`:'`ti. Citation 1 Item 6 Type of violation: Serious 29 CFR 1910.303(gx2Xi): Live parts of electric equipment operating at 50 volts or more were not guarded against accidental contact by approved cabinets or other forms of approved enclosures, or other means listed under this provision: a) Lower Finish Area: The cover for the control box on the Chicago Jet fold folding machine was missing, exposing live electrical parts. b) Upper Finish Area: The cover plate for the control box on the Chicago Jet fold folding machine was missing, exposing live electrical parts. 10t:..:. :.::<....:::}•::.:<........... ....... ..... lei~:: > : ........:. ....... r... f.::::::.:i4::.i...:..,....n:v:::{ti'•':1....::::::::: f v:v}i}i}':::.}?.}:{'{}:jv }:i-!t\.v...... .... { :. :.:}:........:...........S::.C:{{iL;:::Y:i:b::::}':.:::.�n:v::;!.}}•`.:ii.......:w:::v._::,::.:::f:::x:::rn:h};•}}:_:::.�:.v..w::::v::. •. �.{<{} n-.v..:.::..:•.ay.6f. a v. .:u .\•:hu. .}•::.:K:•.v:::::::{-:i-}:::!:.:::::::;{y::'w: See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee righu and responsibilities. Citation and Notification of Penalty Page 6 of 9 OSHA-2(Rev. 6/93) U.S. Department of Labor Inspection Number: 109166504 Occupational Safety and Health Administration. Inspection Dates: 04/18/95 -04/18/95 Issuance Date: 04/26/95 Citation and Nodficadon of Penalty M'I Company Name: Snow White Sails Inspection Site: 230 Falmouth Road, Hyannis, MA 02601 Citation 2 Item 1 Type of Violation: Other 29 CFR 1910.23(cXl): Open sided floor(s)or platform(s)4 feet or more above the adjacent floor or ground level were not guarded by standard railings (or the equivalent as specified in 29 CFR 1910.23(e)(3xi) through(y)), on all open sides: Receiving Area: . The fall hazard between the upper finish area and the receiving area was not guarded. :, ..i'.v'iC;i.'tC:,\u'T.JO.JnJ.2C.:\\\Y•.: 4f :.•:]G%\.`::` Y.Y•..n`�v iM�.}T.�:,�K.itir{:^n,.�.h � . Citation 2 Item 2 Type of Violation: Other 29 CFR 1910.24(b): Fixed stairs were not provided for access from one structure level to another where operations necessitated travel regularly, daily, or*at each shift: Receiving Area: A set of fixed steps were not provided for employees required to gain access to the upper finish area. M41 �EtT•,.-,?i� i;::`;�'?*cq•.:.c :;:;:t•:.•.:`.zx.;}'•::::;;,:,\ �,• :},�' "cb?2.} `5r.'•'• �.. "{•/' "$}� ..A��-'�J.::;.{{{.}M1+{vK+:Lii`:ti~•�' \•v ..JY:'•: Y-.,.,,n�..'.`i} r��: i4 )� kv:;.: •.v`t\=CJ`�r::;:}}.vii�::\vn{.,:\�.,..::.1.is•.:{:vt::l-r�:i)!P}}:•i:::+Y�ti:J}vJ:rA:-J1 ����+Y�,�} {A'�CJC,\T"'.J]�LiLWY.•:{iA`SC:�::CJr'�n."^F::Y)L!.:{v.Ji ih -.,AtvYM1 .!�Q�C.OriAAC:n\x{�.'y� \r{.i:J.$]S.`.WiiP'AGYiL:<C riF}1$"•]�Q�"'Y;i�S%!3S�J3ttK(+IXv J v�`h'd:�•I • 1� See pages t through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. iwion and Notification of Penalty Page 7 of 9 OSHA-2 (Rev.6/93) 4 U.S. Department of Labor Inspection Numbs. 109106504 M Occupational Safety and Health Administration In on uance Da: 04//118M -04/18/95 Citation and Nodfication of Penalty /2W s , Company Name: Snow White Sails Impec ion Site: 230 Falmouth Road, Hyannis, MA 02601 Citadon 2 Item 3 Type of Violation: Other 29 CFR 1910.147(cxl): 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 inop erative 'pe to accordance wi th 29 CFR 1910.147(cx4): Establishment: The employer failed to establish a written Lockout/Tagout Program. �::::::.:\!CFi;''}:-:::.;\\!C.._.y}:�\`�'.; �- .:>aY v'i"•:v .vkrF�:.:.{:�'6}:FFF:i.'::•:.in }.2. , M1, ;:.a;r'::.:c::z:�,,a\�i'n�:�ecs:;,sa�us `��54, :,�\3`3fc,7m° ��F�:>��������'`}t' '.' ,� }���>'..'�,-.: ..,}..F.Y.-:t�..:,. `',\,\.-�•� Citation 2 Item 4 Type of Violation: Other 29 CFR 1910.303(gx2XH): Enclosures or guards for electric equipment in locations where it would be exposed to physical damage were not arranged and of a strength to prevent such damage to the equipment: Lower Finish Area: The conductors on the left hand side of the Chicago Jet fold folding machine were not guarded, NOW F% ::cc{o}:•:{-}::wa...,...::{x}}'�..::}c.}•.:_}::-}}:F;:}:�... .}-:.:.:.,..:.:...:.::::::.:::i..;:.:�::,-.:.�.,•:,-::.::-,:•:}:5:-.}.,2;.;.:.:::.::}y :,`�cc..:-.a•F':.:d::�"- •:'t.:k.:'.S:.;Gh'F,i..•- .:::.... ..,-..,\',A'3.`afiaheSci�.:}�:3c��.b�•r.-'::cam-''`f•:t'2: :`'' 'f°::::F.�;'F:��?+.' i See pages t through 3 of this Citation and Notification of penalty for information on employer and employs rights and responsbilities. Citation and Notification of Penalty Page 8 of 9 OSHA-2 (Rev. 6193) U.S. Department of Labor Inspection Number: 10916M Ocaipational Safety and Health Administration. Inspection Data: 04/18/95 -04/18/95 Issuance Date: 04/26/95 Aft Citation and Notification of Penalty q,x Company Name: Snow White Sails Inspection Site: 230 Falmouth Road, Hyannis, MA 02601 Citation 2 Item S Type of Violation: filer 29 CFR 1910.1200(exl): 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: Establishment: Bleach and Commercial Detergents. •� '±�.:::iFvy:,.nv Y'Sr: :y.':..•;c {•.•Y<ayi.':��.-:'•�+\..:.\.. \\Y::•y.Y.�:.:,r.•,:;:±y..r !;:y:::2:i:: t;;s'•;>>,\>±`ti±:::>:. (ji xax:±±• :���.} ''}}c;-.:..� �1 �+�°•: :hc..,.}:w.yy, - •:.:c�.:r••- O;?t. �,.. ;;:: . ::. :.. .: ������a���:\ \`��\'\�Z�,'.�'\�\4��-:'"''.ya±b?io-v.:;.�yy;,� �,y, 2F'•x '.y''` •�. Y '\ � - '`bi'w•". Ya\ •,aC-i.yA7:o:rfa.7. G.•MiiNdck. .' .bye '• 9gyyt�'�` ti W. Hartmann Director i See pages i through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Orion and Notification of Penalty Page 9 of 9 OSHA-2 (Rev. 6/93) A] U.S. Department of Labor �. Occupational Safety and Health Administration Boston Area Office South 639 Granite Street4th floor A "d � Braintree, MA 02194 Phone: (617)565-6924 FAX: (617)565-6923 INVOICE/ DEBT COLLECTION NOTICE Company Name: Snow White Sails Inspection Site: 230 Falmouth Road, Hyannis, MA 02601 Issuance Date: 04/26/95 Summary of Penatt[es for Inspection Number 109166504 Chad® 1, Sesions = $ 450.00 CWation 2. Other = $ 0.00 axuh;3��'cxC.Sw:?Su�a�.�z �.::�£.:�s:;.::c•:;..« 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: "DOL-OSHA". 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 full amount due, and will cash the check or money order as if these restrictions, conditions, or endorsements do not exist. `- 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.mot. 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 3%. 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 df 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. Page i of 2 4W RdIng M Cha=. 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 delinquat 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. AdminWmtive 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. g1po W. Hartmann Date I a Director Page 2 of 2 1raA1 \ L qw O 1 A Referral Report r U.S. Departm%ri"of Labor Occupational Safety and Health Administration Moo Date 1. Reportirp ID 2. Y Activity Yes ❑No 3. Referral 901479717 Enter Type: Number: � 1t1 this RBfer 4. a. ❑ b. Establishment Name � ; Change? SW64d 4) A M-S 6. a. ❑ b. Site Add a (Street. City. State, ZIP) ?. City A. County Code 9. Mailing Address(Street, City, State, ZIP) ome 10. of Business 11.Primary SIC 12. No.�Employees T a)Lf !Zc/ 1; L 13.Owner h (Mark "X" in one box) a. rivate Sector b. ❑ Local Government c. ❑State Government d. ❑Federal Agency/Code 14. Referred by: 15.Date Received: a. ❑CSHO (Within office)/CSHO 10 f. ❑Consultation b. ❑Federal OSHA 9 I 00'Late/Local Government c. ❑State OSH h. ❑Media d. ❑'Discrimination i. ❑Other (specify) e. ❑Other Federal Agency/Code 16. Source or Contact (Name, L ation, Affiliation, Telephone ryumber) t � 17. a. Safety b. Health (1)❑ Immanent Danger (2) ER Serious (3) ❑Other (1)❑ Imminent Danger (2) ❑Serious (3) ❑Other 16. ❑Migrant Farmlworker Camp 19. Hazard Description /3�CTS t �uLLeyS A/RG 7-.14 14 v G ►fc b. Date Letter Sent. c. Date Response Due: 21. Supervisor(s)Assigned 20.a. ❑Send Letter a. b. 22.tAsp9ption Planned? If Yes, If No, es n No Priority: I Reason: 23.Transfer to (Name)...---------_---------- ---=r----- - ----- 24. Transfer Date:_____ 2S.Transfer to Cat k ( �ory> c. ❑Other Federal Agency/Code a. ❑Federal OSHA/Reporting ID d. ❑State/Local Government b. ❑State OSH/Reporting ID e. ❑Other 20. Optional Information Type ID Value Type ID Value oa Entries .Comments OSHA-90(Rev. 1/84) �r►"r '�< 40 U.S. Department of Labor Occupational Safety and Health Administration \ Boston Area Office South 639 Granite Street4th floor Braintree, MA 02184 Phone: (617)565-6924 FAX: (617)565-6923 04/26M 109166504 (C6586) Snow White Sails 230 Falmouth Road Hyannis, MA 02601 'Ibe recent inspection of your workplace revealed no instances of Repeated, Willful, or Failure-to-Abate violations, nor were there a significant number,of High Gravity Serious violations. Additionally, the compliance officer has reported that you have a good understandingof the actions to correct the violations necessary o atrons that were cited and that you are will' to make those by the date(s) specified in the citation. Y corrections IU good faith you have exhibited, and the absence of Repeated, Willful, or Failure-to-Abate violations, makes your firm eligible for an Expedited Informal Settlement Agreement (EISA). Under this program, an employer and OSHA can enter into an Informal Settlement Agreement without going through the formal procedure of meeting in the Area Office. However, V you dedde to enter Into the Expedited Informal Settlement Agreement, you should be aware that you relinquish your right to contest the citations and penalties. Mw Expedited Informal Settlement Agreement can be used only where the sole issue of dispute is the dollar amount of proposed penalties. If you wish to discuss, change, or object to any other aspect of the inspection or citations — including abatement dates, validity of violations,classification of violations—then the Expedited Informal Settlement Agreement cannot be used. Under those cira stances, you may request an Informal Conference with me and/or exercise your contest rights as explained elsewhere. You should carefully read the enclosed Expedited Informal Settlement Agreement to determine whether the terms of the agreement are acceptable to you. Key elements of the agreement call for OSHA to agree to a 50 per cent reduction in the total penalty amount proposed; for the Employer to correct the violations by the abatement date(s)set forth in the citation(s); for the Employer to provide evidence of corrective actions taken and to provide written certification that all items have been abated at the time of final abatement. Please note that failure to comply with any of the terms set forth in the agreement will cause the penalty to revert to the to revert to the initially proposed amount. Mw signed agreement and a check for the full amount of the reduced penalty(50 per cent of the total of initially proposed penalties) must be delivered to the Area Office prior to the expiration of the 15-working day contest period. If mailed, the letter must be postmarked not later than the day that the 15-working day contest period ends. If you have any questions regarding the Expedited Informal Settlement Agreement, please contact this office at(617) 565-6924. Sincerely, W. Hartmann Area Director In the matter of: Snow White Sails OSHA/ 109166504 C6586 EXPEDITED INFORMAL SETTLEMENT AGREEMENT The undersigned EMPLOYER and the undersigned Occupational Safety and Health Administration(OSHA),in settlement of the above reference Citation(s) and Notification(s)of Penalty which were issued on April 26, 1995 hereby agree as follows: 1. The EMPLOYER agrees to correct the violations as cited.in the above referenced citation(s). 2. The EMPLOYER agrees to provide evidence of the actions taken to correct the cited violations. 3. Upon correction of all violations, the EMPLOYER agrees to provide written certification to the Area Director that all of the violations have been corrected. The EMPLOYER agrees to post a copy of the written certification for a period of three days in the place the citations were posted as described in paragraph 7 of this AGREEMENT. 4. OSHA agrees that the total penalty is amended to $225.00. Failure of the EMPLOYER to comply with the terms of this AGREEMENT shall cause the penalty to revert to the initially proposed penalty of$450.00. 5. In consideration of the foregoing amendment(s)and/or modification(s)to the citation(s), the EMPLOYER hereby waives its right to contest said citation(s)pursuant to Section 10(c)of the Occupational Safety and Health Act of 1970. It is understood and agreed by the Occupational Safety and Health Administration and the EMPLOYER that the citation(s)as amended and/or modified by this agreement shall be deemed a final order not subject to review by any court or agency. 6. The EMPLOYER agrees to immediately post a copy of this Settlement Agreement in the same manner and place as the Citations (Citations are required by law to be posted in a prominent place at or near the location of the violation(s). Citations must remain posted until the violations cited have been corrected, or for three working days(excluding weekends and federal holidays, whichever is longer). 7. Each party hereby agrees to bear its own fees and other expenses incurred by such party in connection with any stage of this proceeding. FO THE OCCUPATIONAL SAFE TRATION f DATE SfGNEb DATE SIGNED """"NOTICE TO EMPLOYEES******** The law gives you or your representative the opportunity to object.to any abatement date set for a violation if you believe that the date to be unreasonable. Any contest of the abatement dates of the.citations referred to in paragraph 1 of this Settlement Agreement must be mailed to the following address within 15 working day$ (excluding weekends and federal holidays) of the receipt by the EMPLOYER of the ofigi4lcitations: S1r 6 V £Z Zug U.S. Department of Labor Occupational Safety and Health Administration b 639 Granite Street - 4th Floor s n -u Braintree, Massachusetts 02184 (617) 565-6924 I