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Chapter 3.2. California Occupational Safety and Health Regulations (CAL/OSHA)
Subchapter 2. Regulations of the Division of Occupational Safety and Health
ARTICLE 1.5 Employer's Declaration of Abatement and Other Documentation of Abatement-Employee Notification-Posting Requirements.

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§340.4. Declaration of Abatement, Other Documentation, Employee Notification and Posting Requirements

Appendix B to Section 340.4-Sample Abatement Plan or Progress Report


(Name), District Manager

Division of Occupational Safety and Health

Address of the District Office (on the citation)

[Company's Name]

[Company's Address]

Check one:

Abatement Plan [ ]

Progress Report [ ]

Inspection Number:

Page  

of

 

Citation Number(s)*

Item Numbers

Proposed

Action Completion Date (for abatement plans only) Completion Date (for progress plans only) 1. 2.

1.

2.

Date required for final abatement:

I attest that the information contained in this document is accurate.

NOTE: For serious violations the document must be submitted under penalty of perjury. See Appendix A)

Signature

Typed or Printed Name

Name of primary point of contact for questions:

[optional]

Telephone Number:

*Abatement plans or progress reports for more than one citation item may be combined in a single abatement plan or progress report if the abatement actions, proposed completion dates, and actual completion dates (for progress reports only) are the same for each of the citation items.

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