['Enforcement and Audits - OSHA']
['Enforcement and Audits - OSHA']
06/12/2024
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(Name), Area Director
U. S. Department of Labor—OSHA
Address of the Area Office (on the citation)
[Company’s Name]
[Company‘s Address]
The hazard referenced in Inspection Number [insert 9-digit #] for violation identified as:
Citation [insert #] and item [insert #] was corrected on [insertdate] by:
________.
Citation [insert #] and item [insert #] was corrected on [insert date] by:
________.
Citation [insert #] and item [insert #] was corrected on [insert date] by:
________.
Citation [insert #] and item [insert #] was corrected on [insert date] by:
________.
Citation [insert #] and item [insert #] was corrected on [insert date] by:
________.
Citation [insert #] and item [insert #] was corrected on [insert date] by:
________.
Citation [insert #] and item [insert #] was corrected on [insert date] by:
________.
Citation [insert #] and item [insert #] was corrected on [insert date] by:
________.
I attest that the information contained in this document is accurate.
_________________________________ Signature
_________________________________Typed or Printed Name
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Copyright 2025 J. J. Keller & Associate, Inc. For re-use options please contact copyright@jjkeller.com or call 800-558-5011.