State of California Department of Industrial Relations Division of Occupational Safety and Health Fremont District Office 39 4i Civic Center Drive, Suite 310 Fremont, CA 94538 Phone: {510) 794?252] Fax: (510) 7948889 CITATION AND NOTIFICATION OF PENALTY To: Tesla Motors, Inc. Inspection l012976 Inspection Date (5): 12/08/2014 - 05/01/20l5 and its successors Issuance Date: 05/08/20l 5 45500 Fremont Blvd. CSHO iD: E2672 Fremont, CA 94538 Optional Report it: 038-15 Reporting ID: 0950612 Inspection Site: The violationls} described in this Citation and 45500 Fremont Blvd. Notification of Penalty is {are} alleged to have Fremont, CA 94538 occurred on or about the doylsl the inspection was made unless otherwise indicated within the description given below. This Citation and Noti?cation of Penalty (hereinafter Citation) is being issued in accordance with California Labor Code Section 6317 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 workina days, whichever is Ionaer. Violations of Title 8 of the California Code of Regulations or of the California Labor Code may result in some instances in prosecution fora 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 mu_st contact the Appeals Board, in writing or by telephone, within l5 working days from the date of receipt of this Citation. it you miss the I5 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 IO 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 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Noti?cation ot Penafty Page 1 at 15 Rev 12i20t4 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 agreement which resolves this matter without litigation or contest. APPEAL RIGHTS The Occupational Safety and Health Appeals Board (Appeals Board) consists of three members appointed by the Governor. The Appeals Board is a separate entity from the Division of Occupational Safety and Health (Division) and employs experienced attorneys as administrative law judges to hear appeals fairly and impartially. To initiate an appeal from a Citation and Notification of Penalty, you must contact the Appeals Board. in writing or by telephone. within 15 working days from the date of receipt of 0 Citation. After you have initiated your appeal. you must then file a completed appeal form with the Appeals Board. at the address listed below. for each contested citation. Failure to file a completed appeal torn; with the Appeals Board may result in dismissal of the appeal. Appeal forms are available from district offices of the Division. or from the Appeals Board: Occupational Safety and Health Appeals Board 2520 Venture Oaks Way. Suite 300 Sacramento. CA 95833 Telephone: [Pie] 274-5751 or (877] 2524987 Fax: (915) 274-5785 if the Citation you are appealing alleges more than one item. you must specify an the appeal form which items you are appealing. You must also attach to the appeal form a legible copy of the Citation you are appealing. In addition. please send a copy of Page i of this Citation and Notification of Penalty. the cover sheet. Among the specific grounds for an appeal are the following: the safety order was not violated. the classification of the alleged violation le.g.. serious. repeat. willful) is incorrect. the abatement requirements are unreasonable or the proposed penalty is unreasonable. important: You must notify the Appeals Board. not the Division. of your intent to appeal within l5 working days from the date of receipt of the Citation. Otherwise. the Citation and Notification of Penalty becomes a final order of the Appeals Board not subject to review by any court or agency. An informal conference with the Division does not constitute an appeal and does not stay the 15 workina dav appeal period. If you have any questions concerning your appeal rights. call the Appeals Board. at (916) 274?575l or [877) 2524987. See pages 1 through 4 of this Citation and Notification of Penalty for information an employer and employee rights and responsibilities. Citation and Notification of Penalty Page 2 of 15 Rev i2/20l4 PENALTY PAYMENT OPTIONS Penalties are due within 15 working days of receipt of this Citation and Notification of Penalty untess contested. tf you are appealing any item of the citation. remittance is still due on all items that are not appealed. Enclosed for your use is a Penalty Remittance Form for payment. 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 numberlsl 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 94f 42?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 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 160 and/or l?l forms 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 serious and genera! violations has already been reduced by 50% on the presumption that the empfoyer will correct the violations by the abatement date. If the 161 is not received in the district office within 10 days following the abatement date, the abatement credit is revoked, causing the penalty to double. Note: Return the loo/tot forms to the district office listed on the Citation and as shown below: Division of Occupational Safety and Health Fremont District Office 39l 4i Civic Center Drive, Suite 310 Fremont, CA 94538 Telephone: [510] 794?252i Fax: (5l0} 794?388? for information an employer and employee rights and responsibilities. See pages I through 4 of this Citation and Notification of Pen-alt Rev I2,?20irt Citation and Notification of Penalty Page 3 of 15 EMPLOYEE RIGHTS Employer Discrimination Unlawful The law prohibits discrimination by an employer against an employee for filing a complaint or for exercising any rights under Labor Code Section 63l0 or 63i T. An employee who believes that he/she has been discriminated against may file a complaint no tater than six months after the discrimination occurred with the Division of Labor Standards Enforcement. Employee Appeals An employee or authorized employee?s representative may, within l5 working days of the issuance of a citation, special order, or order to take special action, appeal to the Occupational Safety and Health Appeals Board the reasonableness of the period of time fixed by the Division of Occupational Safety and Health (Division) for abatement. An employee appeal may be filed with the Appeals Board or with the Division. No particular 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 document the date of receipt, include any envelope or other proof of the date of mailing, and transmit the document to the Appeals Board. The Division shall, no later than IO 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 it is reasonable. Employee Appeal Forms are available from the Appeals Board, or from a district office of the Division. Employees Participation in Informal Conference - Affected employees or their representatives may notify the District Manager that they wish to attend the informal conference. It the employer objects, a separate informal conference will be held. 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 1-866?326-l?l6 (toll free). The Statewide Coordinator can also be reached through the California Relay Service, by dialing 7ll or 1800?735? 2929 (TTY) or 1?800?855-3000 (er 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 (CART), 0 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. aria Notification of Penalty tar information an employer and employee rights and responsibilities. See pages through 4 of this Citation Rev 32/2014 CllOilOiT and Notification of Penalty Page 4 at 15 State of California Inspection 1012976 Department of industrial Relations Inspection Dates: 12/08/2014 05/0l /2015 Division of Occupational Safety and Health Issuance Date: 05/08/2015 Fremont District Office CSHO ID: E2672 3914i Civic Center Drive, Suite 310 Optional Report 038?1 5 Fremont, CA 94538 Phone: [510) 794?2521 Fax: (510) 794-3889 Citation and Noti?cation of Penalty Company Name: Tesla Motors, inc. Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd. Fremont, CA 94538 Citation i Item I Type of Violation: General T8CCR Section 3203(a} Include procedures for identifying and evaluating work place hazards including scheduled periodic inspections to identity unsafe conditions and work practices. lnspections shall be made to identify and evaluate hazards: When the Program is first established: Whenever new substances, processes, procedures, or equipment are introduced to the workplace that represent a new occupational safety and health hazard; and (C) Whenever the employer is made aware of a new or previously unrecognized nazard. Prior to and during the course of this inspection, including, but not iirnited to, on November 30, 2014, the employer failed to implement an effective Injury and Illness Prevention Program in accordance with this section. Prior to and during the course of this inspection, including, but not limited to, on November 30, 2014, the employer failed to conduct inspection (job hazard analysis) prior to the switch gear preventive maintenance test, and repair of electrical equipment inside Substation 17. Date By Which Violation Must be Abaied: June 07, 2015 Proposed Penalty: $300.00 itation and Notification of Penalty for inforr?nation on eiriployer and employee rigt'ets and See pages: 1 thrr?rugh 4 at lnis Rev 12/2014 Citation and of Penalty Page 5 of 15 State of California Department of Industrial Relations Division at Occupational Safety and Health Fremont District Office 3914i Civic Center Drive, Suite 310 inspection l012976 yeti": inspection Dates: 12/08/2014 05/01 r201 5 Issuance Date: 5 ?T-t?j?s csno lD: E2672 Optional Report 038?l 5 Fremont, CA 94538 Phone: (510) 794?2521 Fax: {SiOl 794-3889 Citation and Noti?cation of Penalty Company Name: Tesla Motors, inc. Establishment DBA: and its successors 45500 Fremont Blvd. Fremont, CA 94538 Inspection Site: Citation i Item 2 Type of Violation: General Section 33i Hazardous Energy Control Procedures. A hazardous energy control procedure shall be developed and utilized by the employer when employees are engaged in the cleaning, repairing, servicing setting-up or adjusting at prime movers, machinery and equipment, The employer's hazardous energy control procedures shall be documented in writing. (A) The employer's hazardous energy control procedure shall include separate procedurai steps for the safe iockout/tagout of each machine or piece of equipment affected by the hazardous energy control procedure. Prior to and during the course of this inspection. including, but not limited to, on November 30, 2014, the employer failed to develop separate written procedural steps for the safe de~energizing and re energizing (lockout/tagoutl of the HLV Load interrupter switch gear low and high voltage system, located at Substation l7. June 07, 2015 Date By Which Violation Must be Abated: $800.00 Proposed Penalty: See pages through 4 of tnis Citation and Notification at Penalty for intorntatian or: employer one employee rights and responsibilities. Page 6 at 15 Rev Citation and Notification or Penalty State of California Inspection #1 1012976 rt, Department of Industrial Relations Inspection Dates: l2x?O8/20l4 - 05/0l /201 5 55? 3 Division of Occupational Safety and Health issuance Date: 05/08/2015 iiti'r. ?mag Fremont District Office CSHO iD: E2672 .. 39 i Ail Civic Center Drive, Suite 310 Optional Report #2 038?15 ?(min Fremont, CA 94538 Phone: {5i0i 794?252l Fax: [510) 7948889 Citation and Notification of Penalttr Company Name: Tesla Motors, Inc, Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd. Fremont, CA 94538 Citation 2 item Type of Violation: Serious T8CCR Section 3203ia) 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. Prior to and during the course of this inspection, including, but not limited to, on November 30, 20l 4, the employer failed to implement an effective injury and illness Prevention Program in accordance with this section. Prior to and during the course of this inspection, including, but not limited to, on November 30, 20M, the employer failed to communicate to all employees of the re-energizing the Type HVL Load interrupter t7Atl t2i