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Indiana Department of :labor <br />Indiana Occupational Safety and Health Administration <br />402 West Washington St - Room W195 <br />Indianapolis, IN 46204 <br />Phone: (317)232-1979 FAX: (317)233-3790 <br />INVOICE/DEBT COLLECTION NOTICE <br />Company Name: Slatile Roofing and Sheet Metal Co Inc <br />Inspection Site: 2015 Western Ave, South Bend, IN 46619 <br />Issuance Date: 8/6/2018 <br />Summary of Penalties for Inspection Number: 318098555 <br />Safety Order 1, Serious <br />= $3,000.00 <br />Safety Order 2, Repeat <br />= $4,200.00 <br />TOTAL PENALTIES <br />= $7,200.00 <br />Penalties are due within fifteen (15) working days of receipt of this notification unless contested. Make <br />your check or money order payable to: "Indiana DOL/IOSHA'. Please indicate IOSHA's Inspection <br />Number (indicated above) on the remittance. <br />IOSHA does not agree to any restrictions or conditions or endorsements put on any check or money <br />order for less than full amount due, and will cash the check or money order as if these restrictions, <br />conditions, or endorsements do not exist. <br />Corrective action, taken by you for each alleged violation should be submitted to this office on or about <br />the abatement dates indicated on the Safety Order and Notification of Penalty. <br />/11 <br />A wo sheet een provided to assist in providing the required abatement information. A completed <br />copy f`Ps w r sheet sltuld be posted at the worksite with the safety order(s). <br />Jerry W. Lander <br />Direc r of Cory <br />Safety <br />p, a ,ems zoia <br />Date <br />Safety Order and Notification of Penalty Page 1 (Rev 9/13) <br />