State of California Department of Industrial Relations Division of Occupational Safety and Health Fremont District Office 39141 Civic Center Drive, Suite 310 Fremont, CA 94538 Phone: (510) 794-2521 Fax: (5101 794?3889 CITATION AND NOTIFICATION OF PENALTY To: Tesla, Inc, Inspection 1268303 Inspection Date (5): 10/04/2017 - 01/17/2018 and its successors Issuance Date: OI 8 45500 Fremont Blvd. CSHO ID: Q7698 Fremont, CA 94538 Optional Report 001?18 Reporting ID: 0950612 Inspection Site: The violation{sl described in this Citation and 45500 Fremont Blvd. Notification of Penalty is (are) alleged to have Fremont, CA 94538 occurred on or about the day{s) the inspection was made unless otherwise indicated within the description given below. This Citation and Notification of Penalty (hereinafter Citation] is being issued in accordance with California Labor Code Sections 6317 and 6320 for violations that were found during the inspection/ investigation. This Citation or a copy must be prominently posted upon receipt by the employer at or near the location of each violation until the violative condition is corrected or for three workinq davs, whichever is lonaer. Violations of Title 8 of the California Code of Regulations or of the California Labor Code may result in some instances in prosecution for a misdemeanor. YOU HAVE A RIGHT to contest this Citation and Notification of Penalty by filing an appeal with the Occupational Safety and Health Appeals Board. To initiate your appeal, you must contact the Appeals Board, in writing or by telephone, within 15 working days from the date of receipt of this Citation. If you miss the 15 working day deadline to appeal, the Citation and Notification of Penalty becomes a final order of the Appeals Board, not subject to review by any court or agency. Informal Conference You may request an informal conference with the manager of the district office which issued the Citation within 10 working days after receipt of the Citation. However, if the citation is appealed, you may request an informal conference at any time prior to the day of the hearing. Employers are encouraged to schedule a conference at the earliest possible time to assure an expeditious resolution of any issues. At the informal conference, you may discuss the existence of the alleged violation, classification of the violation, abatement date or proposed penalty. See pages I through 5 of this Citation and Notification of Penatty for information an employer and employee rights and responsibilities, Citation and Notification of Penalty Page I of 15 V2 Rev 2t2015 Be sure to bring to the conference ony ond oll supporting documentation of existing conditions as well 03 ony obotement steps token thus for. If conditions worront. we con enter into on ogreement which resolves this motter without titigotion or contest. APPEAL RIGHTS The Occupotionol Sofety ond Heolth Appeols Boord (Appeols Boord) consists of three members oppointed by the Governor. The Appeols Board is seporote entity from the Division of Occupotionol Sofety ond t-leolth (Division) ond employs experienced ottorneys os odministrotive low judges to heor oppeols fdirly ond importiolly. To initiote on appeal from Citotion and Notification of Penolty, you must contoct the Appeols Boord, in writing or by telephone, within 15 working doys from the dote of receipt of Citotion. After you hove initioted your oppeol, you must then file 0 completed oppeol form with the Appeols Boord, ot the oddress listed below, for eoch contested citotion. Foiture to file 0 completed oppedl form with the Appedls Boord may result in dismissot of the appeal. Appeol forms ore ovoiloble from district offices of the Division, or from the Appeots Boord: Occupdtionol Sofety and Health Appedls Boord 2520 Venture Ooks Way, Suite 300 Socromento, CA 95833 Telephone: (916) 274?575] or (877) 252-1987 Fox: (916) 274-5785 If the Citotion you ore oppeoling olleges more then one item, you must specify on the Oppeol form which items you are oppeoling. You must olso ottoch to the oppeol form or legible copy of the Citotion you ore oppedling. In addition, pleose send 0 copy of Poge of this Citotion ond Notificotion of the cover sheet. Among the specific grounds for on oppeol ore the following: the safety order was not violoted, the clossificotion of the olleged violotion serious, repeot, willful} is incorrect, the obotement requirements ore unreosonoble or the preposed penolty is unreosonoble. Important: You must notify the Appeols Boord, not the Division, of your intent to oppeol within l5 working doys from the dote of receipt of the Citotion. Otherwise, the Citotion ond Notificotion of Penolty becomes 0 ftnol order of the Appeols Boord not subject to review by ony court or ogency. An informol conference with the Division does not constitute on oppeol ond does not stov the 15 working dov oppeol period. if you hove ony questions concerning your oppeol rights, coll the Appeols Board, of (916) 274?5751 or [877) 252?1987. See pages through 5 of this Citotion ond Notificotion of Penotty for informotion on employer ond employee rights ond responsibilities. Citotion and Notification of Penalty Page 2 of 15 V2 Rev 2I20t5 PENALTY PAYMENT OPTIONS For general/regulatory violations, and for serious violations that have been abated, penalties are due within l5 working days of receipt of this Citation and Notification of Penalty unless contested. If you are appealing any item of the citation, remittance is still due on all items described above that are not appealed. Enclosed for your use is a Penalty Remittance Form for payment. For serious violations that are not abated, if a signed statement of abatement (as described under "Notification of Corrective Action", below) is n_ot timely received or if the statement does n_ot demonstrate acceptable abatement, penalties will be due within l5 working daysafter the date the signed statement was due, unless contested. For serious violations for which a signed statement of abatement demonstrating acceptable abatement is timely received, the payment due date will be described in a Modified Citation and Notification of Penalty that you will receive reflecting a 50% abatement credit. If you are paying electronically, please have the Penalty Remittance Form on?hand when you are ready to make your payment. The company name, inspection number, and Citation num'berls) will be required in order to ensure that the payment is accurately posted to your account. Please go to to access the secure payment processing site. Additionally, you must also mail the Penalty Remittance Form to the address below. If you are paying by check, return one copy of the Citation, along with the Notice of Proposed Penalties Sheet and the Penalty Remittance Form and mail to: Department of Industrial Relations Cashier, Accounting Office P. O. Box 420603 San Francisco, CA 94142?0603 does not agree to any restrictions, conditions or endorsements put on any check or money order for less 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 general/regulatory violations which you do not contest, you should notify the Division of Occupational Safety and Health by letter that you have taken appropriate corrective action within the time frame set forth on this Citation and Notification of Penalty. Please inform the district office listed on the Citation by submitting the l60 form with the abatement steps you have taken and the date the violation was abated, together with adequate supporting documentation, drawings or photographs of corrected conditions, purchase/work orders related to abatement actions, air sampling results, etc. The adjusted penalty for general violations has already been reduced by 50% on the presumption that the employer will correct the violations by the abatement date. The adjusted penalty for serious violations that have been abated, if any, has already been reduced by 50% because abatement of those violations has been completed. See pages through 5 of this Citation and Notification of Penalty for information an employer and employee rights and responsibilities. Citation and Notification of Penalty Page 3 of I5 V2 Rev 2/20l 5 The adiusfed penalfy for serious violafions ThaT have noT been aba.ed will be reduced by 50% if The Division of Occupafional SafeTy and HealTh receives from you wiThin 10 working days following The abaTemenT daTe a signed sTaTemenT under penalfy of perjury form 161) and sufficienf supporfing evidence, when necessary To prove abaTemenT, demonsTraTing abaTemenT accepiable To The Division. If The Division does noT receive The sTaTemenT of abaiemenf wifhin l0 working days afTer The abaTemenT dafe, The adiusfed penalfy will n_o_T be reduced by 50% egardless of wheTher you appeal The serious ciTaTions. NoTe: Refurn The i?o/i?i forms To The disfricT office lisTed on The CiTaTion and as shown below: Division of Occupafional SafeTy and HealTh FremonT Disfricf Office 39i 4] Civic CenTer Drive, Suife 3i0 FremonT, CA 94538 Telephone: (510) 794?2521 Fax: (510) 794?3889 EMPLOYEE RIGHTS Employer Discrimination Unlawful The law prohibifs discriminafion by an employer againsT an employee for filing a complainT or for exercising any righTs under Labor Code SecTion 6310 or 631 T. An employee who believes ThaT he/she has been discriminafed againsf may file a complainf no laTer Than six (6) monfhs afTer The discriminafion occurred wiTh The Division of Labor Sfandards Enforcemenf. Employee Appeals An employee or auThorized employee's represenTaTive may, wiThin 15 working days of The issuance of a ciTaTion, special order, or order To Take special acTion, appeal To The Occupafional SafeTy and HealTh Appeals Board The reasonableness of The period of Time fixed by The Division of Occupafional SafeTy and HealTh (Division) for abaTemenT. An employee appeal may be filed wiTh The Appeals Board or wiTh The Division. No parficular formaT is necessary To iniTiaTe The appeal, buT The noTice of appeal be in wriTing. if an Employee Appeal is filed wiTh The Division, The Division shall noTe on The face of The documenf The daTe of receipT, include any envelope or oTher proof of The dafe of mailing, and TransmiT The documenf To The Appeals Board. The Division shall, no laTer Than 10 working days from receipT of The Employee Appeal, file wiTh The Appeals Board and serve on each. parTy a clear and concise sTaTemenT of The reasons why The abaTemenT period prescribed by TT is reasonable. Employee Appeal Forms are available from The Appeals Board, or from a disTricT office of The Division. Employees ParTicipaTion in informal Conference- Affecfed employees or Their represenfaiives may noTify The DisTricT Manager ThaT They wish To aTTend The informal conference. If The employer objecTs, a separaTe informal conference will be held. See pages Through 5 of This CiTaTion and NoTificaTion of Penalfy for informaiion an employer and employee righfs and responsibilities. Cifafion and Nofificafion of Penalty Page 4 of 15 V2 Rev 2X20l 5 DISABILITY ACCOMMODATION Disability accommodation is available upon request. Any person with a disability requiring an accommodation, auxiliary aid or service, or a modification of policies or procedures to ensure effective communication and access to the programs of the Division of Occupational Safety and Health, should contact the Disability Accommodation Coordinator at the local district office or the Statewide Disability Accommodation Coordinator at i?866?326-l?i? (toll free). The Statewide Coordinator can also be reached through the California Relay Service, by dialing 7i i or 1-800?735- 2929 (TTY) or l?800~855?3000 (TTY - Spanish). Accommodations can include modifications of policies or procedures or provision of auxiliary aids or services. Accommodations include, but are not limited to, an Assistive Listening System (ALS), a Computer?Aided Transcription System or Communication Access Realtime Translation a sign?language interpreter, documents in Braille, large print or on computer disk, and audio cassette recording. Accommodation requests should be made as soon as possible. ReqUests for an ALS or CART should be made no later than five (5) days before the hearing or conference. See pages through 5 of this Citation and Notification of Penalty for information an employer and employee rights and responsibilities. Citation and Notification of Penalty Page State of California Inspection I2ou803 Department of Industrial Relations Inspection Dates: 7 0i /l 8 Division of Occupational Safety and Health Issuance Date: 0i/l7/2018 Fremont District Office CSHO ID: Q7698 39l4l Civic Center Drive, Suite BIO Optional Report OOI -18 Fremont, CA 94538 Phone: (SIO) 794-252) Fax: 794-3889 Citation and Notification of Penalty Company Name: Tesla, Inc. Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd. Fremont, CA 94538 Citation I Item I Type of Violation: General T8 CCR 3203: (0) Effective July I, I99), every employer shall establish, implement and maintain an effective Injury and Illness Prevention Program (Program). The Program shall be in writing and, shall, at a minimum: (3) Include a system for communicating with employees in a form readily understandable by all affected employees on matters relating to occupational safety and health, including provisions designed to encourage employees to inform the employer of hazards at the worksite without fear of reprisal. Substantial compliance with this provision includes meetings, training programs, posting, written communiCations, a system of anonymous notification by employees about hazards, labor/management safety and health committees, or any other means that ensures communication with employees. (6) Include methods and/or procedures for correcting unsafe or unhealthy conditions, work practices and work procedures in a timely manner based on the severity of the hazard: (A) When observed or discovered; and, (B) When an imminent hazard exists which cannot be immediately abated without endangering employee(s) and/or property, remove all exposed personnel from the area except those necessary to correct the existing condition. Employees necessary to correct the hazardous condition shall be provided the necessary safeguards. Prior to and during the course of inspection, the employer failed to implement an effective Injury and Illness Prevention Program in the following instances: (I) The employer did not effectively communicate to all affected employees on matters relating to occupational safety and health, in that employees were unaware of the employers program for voluntary PPE use, employees do not receive effective communications on the hazards in their work areas and results of any air monitoring performed, and any communication on the corrective actions that are being taken to mitigate hazards in the workplace. (2) On October 24, 20l 7, management did not effectively communicate to employees nor was there a system of communication to the Safety Department of the water leakage that occurred in the See pages I through 5 of this Citation and Notification of Penalty for information an employer and employee rights and responsibilities. Citation and Notification of Penalty Page 6 of is V2 Rev 2/20) 5 paint department I-Line in whicn employees were exposed to stand? Ig water in their work areas. (3) On October 24, 2017, the employer did not implement any corrective action to protect employees from exposure to the standing water in the point department in a timely manner when it was ?rst discovered and observed. Corrected During Inspection Date By Which Violation Must be Abated: Corrected During Inspection Proposed Penalty: $1060.00 See pages 1 through 5 of this Citation Notificotion of Penalty for information on employer and employee rights and responsibilities Citation and Notification of Penalty Page 7 of is 2 V2 Rev 2/20t5 State of California Inspection 1208803 Department of Industrial Relations Inspection Dates: l0/04/2017 - 01/17/2018 Division of Occupational Safety and Health Issuance Date: 01/17/2018 Fremont District Office CSHO 1D: Q7698 3914i Civic Center Drive, Suite 310 optional Report #100148 Fremont, CA 94538 Phone: (510) 794?2521 Fax: (510) 794?3889 Citation and Notification of Penalty Company Name: Tesla, Inc. Establishment BSA: and its successors Inspection Site: 45500 Fremont Blvd. Fremont, CA 94538 Citation I Item 2 Type of Violation: General T8 CCR 5194: Employee Information and Training. (1) Employers shall provide employees with effective information and training on hazardous chemicals in their work area at the time of their initial assignment, and whenever a new chemical hazard is introduced into their work area. Information and training may relate to general classes of hazardous chemicals to the extent appropriate and related to reasonably foreseeable exposures of the job. Chemical-specific information must always be available through labels and safety data sheets. Reference Subsection (2): (2) information and training shall consist of at least the following topics: (A) Employees shall be informed of the requirements of this section. (B) Employees shall be informed of any operations in their work area where hazardous chemicals are present. (C) Employees shall be informed of the location and availability of the written hazard communication program, including the list(s) of hazardous chemicals and safety data sheets required by this section. (D) Employees shall be trained in the methods and observations that may be used to detect the presence or release of a hazardous chemical in the work area (such as monitoring conducted by the employer, continuous monitoring devices, visual appearance or odor of hazardous chemicals when being released, etc). (E) Employees shall be trained in the physical, health, simple combustible dust and pyrophoric gas hazards, as well as hazards not otherwise classified, of the chemicals in the work area, and the measures they can take to protect themselves from these hazards, including specific procedures the employer has implemented to protect employees from exposure to hazardous chemicals, such as appropriate work practices, emergency procedures, and personal protective equipment to be used. (F) Employees shall be trained in the details of the hazard communication program developed by the employer, including an explanation of the labels received on shipped containers and the workplace labeling system used by their employer and the safety data sheet, and how employees can obtain and use the appropriate hazard information. (G) Employers shall inform employees of the right: I. To personally receive information regarding hazardous chemicals to which they may be exposed, according to the provisions of this section; See pages 1 through 5 of this Citation and Notification of Penalty for information an employer and employee rights and responsibilities, Citation and Notification of Penalty Page 8 of IS V2 Rev 2/2015 2. For their physician or collective bargaining agent to receive information regarding hazardous chemicals to which the employee may be exposed according to provisions of this section: 3. Against discharge or other discrimination due to the employee's exercise of the rights afforded pursuant to the provisions of the Hazardous Substances Information and Training Act. Reference T8 CCR ?5l50(f): Hazard communication. The employer shall include the potentially hazardous materials employed in fluxes, coatings, coverings, and filler metals, all of which are potentially used in welding and cutting, or are released to the atmosphere during welding and cutting, in the program established to comply with the Hazard Communication Standard (Section SI 94). The employer shall ensure that each employee has access to labels on containers of such materials and safety data sheets, and is trained in accordance with'the provisions of Section 51 94. Potentially hazardous materials shall include but not be limited to the materials listed in Articles IO7, and MD of these Orders. Additional considerations for hazard communication in welding, cutting, and brazing. (A) The suppliers shall determine and shall label in accordance with Section 5l94 any hazards associated with the use of their materials in welding, cutting, and brazing. (B) In addition to any requirements imposed by Section 5194, all filler metals and fusible granular materials shall carry the following notice, as a minimum, on tags, boxes, or other containers: Do not use in areas without adequate ventilation. See ANSI Z49.l-l 967 Safety in Welding, Cutting, and Allied Processes published by the American Welding Society. (C) Where brazing (welding) filler metals contain cadmium in significant amounts. the labels shall indicate the hazards associated with cadmium including cancer, lung and kidney effects, and acute toxicity effects. (D) Where brazing and gas welding fluxes contain fluorine compounds. the labels shall indicate the hazards associated with fluorine compounds including and respiratory tract effects. Prior to and during the course of inspection, the employer failed to provide employees with effective information and training on hazardous chemicals in their work area to the extent appropriate and related to reasonably foreseeable exposures ofthe job to include but not limited to the following; l) employees were unaware of the location and availability of Safety Data Sheets and the written hazard communication program; 2) employees were unaware of the results of any air monitoring that have been conducted currently or previously in the Body Center, Powertrain, and General Assembly work areas: 3) employees did not receive information about the hazards of chemicals or substances and the protection the employer has implemented to protect employees from such exposures: and 4) Employees did not receive Information about operations in their work areas or near their work areas, of the presence of hazardous chemicals and measures they can take to protect themselves from such. "Date By Which Violation Must be Abated 7 . .. . . . February16,2018_ Proposed Penalty: - . - - - $1060.00 See pages 1 through 5 of this Citation and Notification of Penalty for information an employer and employee rights and responsibilities. Citation and Notification of Penalty Page 9 of [5 V2 Rev 2/20l 5 State of California Inspection - 120:5303 Department of Industrial Relations Inspection Dates: 7 - 0l/l 7/20l8 Division of Occupational Safety and Health Issuance Date: 0i 7/2018 Fremont District Office CSHO ID: Q7698 39l4l Civic Center Drive, Suite 310 Optional Report 00] -I8 Fremont, CA 94538 Phone: (5l0) Fax: (510) 794-3889 Citation and Notification of Penalty Company Name: Tesla, Inc. Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd. Fremont, CA 94538 Citation I Item 3 Type of Violation: General T8 CCR 3380: If) Hazard assessment and equipment selection. (I I The employer shall assess the workplace to determine if hazards are present, or are likely to be present, which necessitate the use of personal protective equipment (PPE). If such hazards are present, or likely to be present, the employer shall: (A) Select, and have each affected employee use, the types of PPE that will protect the affected employee from the hazards identified in the hazard assessment: (8) Communicate selection decisions to each affected employee; and, (C) Select PPE that properly fits each affected employee. Prior to and during the course of inspection, the employer did not effectively assess the workplace, such as the Body in White Department, to determine the chemical hazards present, or are likely to be present, and select and communicate to employees the types of PPE to be used to protect employees from such hazards. Date By Which_'V_iola_tion be Aba_ted: - . I February 16', 2018 ProposedPenalty: . . - - $635.00 See pages 1 through 5 of this Citation and Notification of Penatty for information an employer and employee rights and responsibilities. Citation and Notification of Penalty Page ii] of IS V2 Rev 5 State of California Inspection l20u503 Department of Industrial Relations Inspection Dates: 7 - 7/20l8 Division of Occupational Safety and Health Issuance Date: Ol/l 7/20l8 Fremont District Office CSHO ID: ?7698 3914] Civic Center Drive, Suite 3t 0 Optional Report 001?l8 Fremont, CA 94538 Phone: l5I0) 794?252l Fax: (510) 794?3889 Citation and Notification of Penalty Company Name: Tesla, Inc. Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd. Fremont, CA 94538 Citation 1 item 4 Type of Violation: General T8 CCR 5049: Special custom design grabs, hooks, clamps, or other lifting accessories for such units as modular panels, prefabricated structures and similar materials, shall be marked to indicate the safe working loads and shall be proof-tested to l25 percent of the rated load prior to use. Reference T8 CCR 5049(9) (l l: Shackles. Employers must ensure that shackles: it) Have permanently affixed and legible identification markings as prescribed by the manufacturer that indicate the recommended safe working load: Prior to and during the course of inspection, the employer failed to ensure the custom designed battery hook and the lifting assembly which includes several shackles and connectors used for lifting battery pack modules was marked to indicate the safe workings loads and have permanently affixed and legible identification markings as prescribed by the manufacturer. Date By Which Violation Must be Abated: . . - February 16, 2018' Proposed Penalty: - - $850. 00' See pages I through 5 of this Citation and Notification of Penalty for information an employer and employee rights and responsibilities. Citation and Notification of Penalty Page II of 15. V2 Rev 2/20l 5 State of California Inspection it: 1260003 Department of Industrial Relations Inspection Dates: 10/04/20i 7 - 01/17/2018 Division of Occupational Safety and Health Issuance Date: 01/17/20l8 Fremont District Office CSHO ID: @7698 39141 Civic Center Drive, Suite BIO Optional Report 001?18 Fremont, CA 94538 Phone: (510) 7942521 Fax: {510) 794?3889 Citation and Notification of Penalty Company Name: Tesla, Inc. Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd. Fremont, CA 94538 Citation i Item 5 Type of Violation: General T8 CCR 5143: Design and Operation. The construction, installation, inspection, testing, and maintenance of exhaust systems shall conform to all requirements of Article 107. Additional guidance may be obtained from the American National Standard Fundamentals Governing the Design and Operation of Local Exhaust Systems, ANSI 292-1971 and the Standard for the Installation of Blower and Exhaust Systems, NFPA No. 91-1973. Note:Ventilation requirements for control of flammable vapors are prescribed in Sections 5153(d] and 5416. The ventilation rate of every mechanical ventilation system used to prevent harmful exposure shall be tested after initial installation, alterations, or maintenance, and at least annually, by means of a pitot traverse of the exhaust duct or equivalent measurements. Records of these tests shall be retained for at least five years. Prior to and during the course of inspection, the employer failed to test and keep records of the ventilation rate by means of a pitot traverse or equivalent measurements of the local exhaust system of the cooling tube brazer machines after initial installation, alterations, or maintenance and at least annually. Corrected During Inspection Date By Which Violation Most be Abated: I . Corrected During Inspection Proposed Penalty: - - . $850 00 k} Ke??y Tatam Compliance Officer/ District Manager See pages 1 through 5 of this Citation and Notification of Penalty for information an employer and employee rights and responsibilities. Citation and Notification of Penalty Page 12 of 15 V2 Rev 2/2015 State of California Department of Industrial Relations Division of Occupational Safety and Health Fremont District Office 39141 Civic Center Drive, Suite 310 Fremont, CA 94538 Phone: (510) 794?2521 Fax: [510} 794?3889 NOTICE or PROPOSED PENALTIES Company Name: Tesla, Inc. Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd, Fremont, CA 94538 Mailing Address: 45500 Fremont Blvd, Fremont, CA 94538 Issuance Date: 01/17/2018 Reporting ID: 0950612 CSHO ID: Q7698 Summary of Penalties for Inspection Number 1268303 Citation 1 Item 1,Genera $1060.00 Citation 1 Item 2, General $1060.00 Citation 1 Item 8, General $635.00 Citation 1 Item 4, General $850.00 Citation 1 Item 5, General $850.00 TOTAL PROPOSED PENALTIES: $4455.00 Penalties are due within 15 working days of receipt of this notification unless contested. If you are appealing any item of this citation, remittance is still due on all items that are not appealed. Enclosed for your use is a Penalty Remittance Form. If you are paying electronically: Please have this form on?hand when you are ready to make your payment. The company name, reporting ID and Citation numberls) will be required to ensure that the payment is accurately posted to your account. Please go to to access the secure payment processing site. Additionally, you must also mail the Penalty Remittance Form to the address below. If you are paying by check: Mail this Notice of Proposed Penalties, the Penalty Remittance Form, along with a copy of the Citation and Notification of Penalty to: DEPARTMENT OF INDUSTRIAL RELATIONS CASHIER, ACCOUNTING OFFICE P. 0. BOX 420603 SAN FRANCISCO, CA 94142?0603 does not agree to any restrictions, conditions or endorsements put on any check or money order for less than the full amount due,_and will cash the check or money order as if these restrictions, conditions or endorsements do not exist. See pages 1 through 5 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 13 of 15 V2 Rev 2/2015