Notice Of Verification Of Abatement Of Serious Violations {CAL-OSHA 161A}

STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF OCCUPATIONAL SAFETY AND HEALTH 1. Office: NOTICE OF VERIFICATION OF ABATEMENT OF SERIOUS VIOLATIONS 2. 3. Page _____ of _____ 4. During the course of an inspection or re-inspection at a place of employment located at: Street City State Zip The Division has verified abatement of the following Citation(s) alleging a serious violation or Special Order(s) or Order(s) to Take Special Action: Citation or Order No. Number of Instances Date Division Verified Abatement 6. Signature: Engineer/Industrial Hygienist 7. Date of Issuance: This notice is provided to the employer in accordance with the provisions of California Labor Code Section 6318(b). The employer is required to post this notice for three (3) working days at or near the location of the alleged violation. 8. Region District Inspection No. Engineer/IH ID No. Cal/OSHA Rpt No. Fiscal Year CAL/OSHA 161A (09/01/00) American LegalNet, Inc. www.FormsWorkflow.com