Citation and Notification of Penalty Page 2 OSHA-2
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.
If you decide to request an informal conference, please complete, remove and post the Notice to Employees next
to this Citation and Notification of Penalty as soon as the time, date, and place of the informal conference 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. 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 that you intend
to contest the citation(s) and/or proposed penalty(ies) within 15 working days after receipt, the citation(s)
and the proposed penalty(ies) will become a final order of the Occupational Safety and Health Review
Commission and may not be reviewed by any court or agency.
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. You can also make your payment electronically at www.pay.gov. At the top of the pay.gov homepage,
type "OSHA" in the Search field and select Search. From OSHA Penalty Payment Form search result, select
Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
You will be required to enter your inspection number when making the payment. Payments can be made by
credit card or Automated Clearing House (ACH) using your banking information. Payments of $25,000 or more
require a Transaction ID, and also must be paid using ACH. If you require a Transaction ID, please contact the
OSHA Debt Collection Team at (202) 693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or
electronic payment for less than the full amount due, and will process the payments as if these restrictions or
conditions do not exist.
Notification of Corrective Action – For each violation which you do not contest, you must provide
abatement certification to the Area Director of the OSHA office issuing the citation and identified above. This
abatement certification is to be provided by letter within 10 calendar days after each abatement date. Abatement
certification includes the date and method of abatement. If the citation indicates that the violation was corrected
during the inspection, no abatement certification is required for that item. The abatement certification letter must
be posted at the location where the violation appeared and the corrective action took place or employees must
otherwise be effectively informed about abatement activities. A sample abatement certification letter is enclosed
with this Citation. In addition, where the citation indicates that abatement documentation is necessary, evidence
of the purchase or repair of equipment, photographs or video, receipts, training records, etc., verifying that
abatement has occurred is required to be provided to the Area Director.
Employer Discrimination Unlawful – The law prohibits discrimination by an employer against an