InspectionNumber: Indiana Department of Labor Occupational Safety and Health Administration 318090651 Inspection Date(s): 9/25/2017-9/27/2017 Issuance Date: 10/26/2017 CSHOID: B6160 Optional ReportNo.: 0076-18 Safety Order and Notification of Penalty CompanyName: Amazon.com Inc. Inspection Site: 800 Perr y Road, Plainfield, Safety Order 01 Item 001 IN 46168 Type of Violation: Serious 29 CFR 1910.147(c)(4)(i): Procedures were not developed, documented and utilized for the control of potentially hazardous energy when employees were engaged in activities covered by this section: On or about 09/24/2017@ 12:56 pm, maintenance employee was exposed to a struck by hazard while working on a powered iodustrial truck and not utilizing LOTO p rocedures while working underneath the mast assembly with forks attached (weighiog est. 1,200 pounds). Date By Which Violation Must Be Abated: 12/1/2017 Proposed Penalty: $7,000.00 Safety Order and Notification of Penally Page 6 of9 OSHA-2 (Rev 1/14) · · Indiana Department of Labor Inspection Number: 318090651 Occupational Safety and Health Administration Inspection Date(s): 9/25/2017 - 9/27/2017 Issuance Date: 10/26/2017 CSHOID: B6160 OptionalReport No.: 0076-18 Safety Order and Notification of Penalty Company Name: Arnazon.com Inc. Inspection Site: 800 Perry Road, Plainfield, IN 46168 Safety Order 01 Item 002 Type of Violation: Serious 29 CFR 1910.147(c)(7 )(i): The employer did not provide adequate training to ensure that employees acquired the knowledge and skills required for the safe application, usage and removal of energy control devices: On or about 09/24/2017@ 12:56 pm, maintenance employee was exposed to a struck by hazard while working on a powered industrial truck without LOTO training to recognize hazards while working underneath the mast assembly with forks attached (weighing est 1,200 pounds). Date By Which Violation Must Be Abated: 12/112017 Proposed Penalty: $7,000.00 Safety Order and Notification of Penalty Page 7 of9 OSHA-2 (Rev 1/14) Indiana Department of Labor InspectionNumber: 318090651 Occupational Safety and Health Administration Inspection Date(s): 9/25/2017 - 9/27/2017 Issuance Date: 10/26/2017 CSHOID: B6160 Optional ReportNo.: 0076-18 Safety Order and Notification of Penalty Company Name: Amazon.com Inc. Inspection Site: 800 Perry Road, Plainfield, JN 46168 Safety Order 01 Item 003 Type of Violation: Serious 29 CFR 1 910.147(d)(3): All energy isolating devices that were needed to control the energy to the machine or equipment were not physically located and operated in such a manner as to isolate the machine or equipment from the energy source(s): On or about 09/24/2017@ 12:56 pm, maintenance employee was exposed to a struck by hazard while working on a powered industrial truck and not utilizing LOTO devices such as but not limited to safety stand while working underneath the mast assembly with forks attached (weighing est. 1,200 pounds). Date By Which Violation Must Be Abated: 12/1/2017 Proposed Penalty: $7,000.00 Safety Order and Notification ofPenal1y Page 8 of9 OSHA-2 (Rev 1/14) Indiana Department of Labor InspectionNumber: Occupational Safety and Healfu A4minis1ration Inspection Date(s): 318090651 9/25/2017- 9/27/2017 Issuance Date: 10/26/2017 CSHOID: B6160 Optional ReportNo.: 0076-18 Safety Order and Notification of Penalty CompanyName: Inspection Site: Amazon.com Inc. 800 Perry Road, Plainfield, IN 46168 Safety Order 01 Item 004 Typ e of Violation: Serious 29 CFR 191 0.147( d)(5)(i): All potentially hazardous stored or residual energy was not relieved, disconnected, res1rained or ofuerwise rendered safe after fue application of lockout or tagout devices to energy isolating devices: or about 09/24/2017 @ 12:56 pm, maintenance employee was exposed to a struck by hazard while working on a powered industrial truck and not utilizing LOTO devices while working nndemeafu a mast assembly of fuePIV wifu forks attached (weighing est. 1,200 ponnds). On Date By Which Violation Must Be Abated: 12/112017 Proposed Penalty: $7,000.00 Director of General Industry Srlety Order and Notification of P enalty Page9 of9 OSHA-2 (Rev 1/14) Indiana Department of Labor Indiana Occupational Safety and Health Administration 402 West Washington St - Room W195 Indianapolis, IN 46204 Phone: (317)232-2691 FAX: (317)233-3790 INVOICE/DEBT COLLECTION NOTICE Company Name: Amazon.com Inc. Inspection Site: 800 Perry Road, Plainfield, IN 46168 Issuance Date: 10/26/2017 Summary of Penalties for InspectiorrNumber: 318090651 Safety Order 1, Serious TOTAL PENALTIES = $28,000.00 = $28,000.00 Penalties are due within fifteen (15) working days of receipt of this notification unless contested. Make your check or money order payable to: "Indiana DOL!rOSHA". Please indicate IOSHA's Inspection · Number (indicated above) on tbe remittance. IOSHA does not agree to any restrictions or conditions or endorsements put on any check or money order for less than full amount due, and will cash the check or money order as if tbese restrictions, conditions, or endorsements do not exist. Corrective action, taken by you for each alleged violation should be submitted to this office on or about tbe abatement d ates indicated on tbe Safety Order and Notification of Penalty. A work sheet has been provided to assist in providing tbe required abatement information. A completed copy of this work sheet should be posted at the worksite with tbe safety order(s). � ll>-U-Zol;' �D. Date J Director of General Industry Safety Order and Notification of Penalty Page 1 (Rev 9/13) ·