U.S. Department of Labor
12/15/2022
Amazon.com Services LLC – ALB1 Fulfillment Center
and its successors
1835 U.S. 9
Castleton On Hudson, NY 12033
Dear Employer:
Enclosed you will find citations for violations of the Occupational Safety and Health Act of 1970 (the Act) which
may have accompanying proposed penalties. Also enclosed is a booklet entitled, “Employer Rights and
Responsibilities Following an OSHA Inspection”, (OSHA 3000-04R) revised 2018, which explains your rights
and responsibilities under the Act. If you have any questions about the enclosed citations and penalties, I would
welcome further discussions in person or by telephone. Please contact me at (518) 464-4338.
You will note on page 6 of the booklet that, for violations which you do not contest, you must (1) notify this
office promptly by letter that you have taken appropriate corrective action within the time set forth on the
citation; and (2) pay any penalties assessed. Please inform me of the abatement steps you have taken and of their
dates together with adequate supporting documentation; e.g., drawings or photographs of corrected conditions,
purchase/work orders related to abatement actions, air sampling results. This information will allow us to close
the case.
As indicated on page 3 of the booklet, you may request an informal conference with me during the 15-working-
day notice of contest period. During such an informal conference you may present any evidence or views which
you believe would support an adjustment to the citation or the penalty.
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of the citation. The running of this contest
period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete the attached notice at the bottom of this letter
and post it next to the Citations as soon as the time, date and the place of the informal conference have been
determined. Be sure to bring to the conference with you any and all supporting documentation of existing
conditions as well as of any abatement steps taken thus far. If conditions warrant, we can enter into an informal
settlement agreement which amicably resolves this matter without litigation or contest.
Occupational Safety and Health Administration
401 New Karner Road, Suite 300
Albany, NY 12205
You should be aware that OSHA publishes information on its inspection and citation activity on the Internet
under the provisions of Electronic Freedom of Information Act. The information related to these alleged
violations will be posted when our system indicates that you have received this citation. You are encouraged to
review the information concerning your establishment at www.osha.gov. If you have any dispute with the
accuracy of the information displayed, please contact this office.
Sincerely,
Rita Young, MS
Area Director
Enclosures
Citation and Notification of Penalty Page 1 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
401 New Karner Road, Suite 300
Albany, NY 12205
Citation and Notification of Penalty
To:
Amazon.com Services LLC – ALB1 Fulfillment
Center
and its successors
1835 U.S. 9
Castleton On Hudson, NY 12033
Inspection Number: 1610874
Inspection Date(s): 08/01/2022 - 12/15/2022
Issuance Date: 12/15/2022
Inspection Site:
1835 U.S. 9
Castleton On Hudson, NY 12033
The violation(s) described in this Citation and
Notification of Penalty is (are) alleged to have
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 (this Citation) describes violations of the Occupational Safety and
Health Act of 1970. The penalty(ies) listed herein is (are) based on these violations. You must abate the
violations referred to in this Citation by the dates listed and pay the penalties proposed, unless within 15 working
days (excluding weekends and Federal holidays) from your receipt of this Citation and Notification of Penalty
you either call to schedule an informal conference (see paragraph below) or you mail a notice of contest to
the U.S. Department of Labor Area Office at the address shown above. Please refer to the enclosed booklet
(OSHA 3000) which outlines your rights and responsibilities and which should be read in conjunction with this
form. Issuance of this Citation does not constitute a finding that a violation of the Act has occurred unless there
is a failure to contest as provided for in the Act or, if contested, unless this Citation is affirmed by the Review
Commission or a court.
Posting - The law requires that a copy of this Citation and Notification of Penalty be posted immediately in a
prominent place at or near the location of the violation(s) cited herein, or, if it is not practicable because of the
nature of the employer's operations, where it will be readily observable by all affected employees. This Citation
must remain posted until the violation(s) cited herein has (have) been abated, or for 3 working days (excluding
weekends and Federal holidays), whichever is longer.
Informal Conference - An informal conference is not required. However, if you wish to have such a
conference you may request one with the Area Director during the 15 working day contest period by calling
(518) 464-4338. During such an informal conference, you may present any evidence or views which you believe
would support an adjustment to the citation(s) and/or penalty(ies).
Citation and Notification of Penalty Page 2 OSHA-2
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of this Citation. The running of this
contest period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete, remove and post the Notice to Employees next
to this Citation and Notification of Penalty as soon as the time, date, and place of the informal conference have
been determined. 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 informal settlement
agreement which amicably resolves this matter without litigation or contest.
Right to Contest – You have the right to contest this Citation and Notification of Penalty. You may contest
all citation items or only individual items. You may also contest proposed penalties and/or abatement dates
without contesting the underlying violations. Unless you inform the Area Director in writing that you intend
to contest the citation(s) and/or proposed penalty(ies) within 15 working days after receipt, the citation(s)
and the proposed penalty(ies) will become a final order of the Occupational Safety and Health Review
Commission and may not be reviewed by any court or agency.
Penalty Payment – Penalties are due within 15 working days of receipt of this notification unless contested.
(See the enclosed booklet and the additional information provided related to the Debt Collection Act of 1982.)
Make your check or money order payable to “DOL-OSHA”. Please indicate the Inspection Number on the
remittance. You can also make your payment electronically at www.pay.gov. At the top of the pay.gov homepage,
type "OSHA" in the Search field and select Search. From OSHA Penalty Payment Form search result, select
Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
You will be required to enter your inspection number when making the payment. Payments can be made by
credit card or Automated Clearing House (ACH) using your banking information. Payments of $25,000 or more
require a Transaction ID, and also must be paid using ACH. If you require a Transaction ID, please contact the
OSHA Debt Collection Team at (202) 693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or
electronic payment for less than the full amount due, and will process the payments as if these restrictions or
conditions do not exist.
Notification of Corrective Action – For each violation which you do not contest, you must provide
abatement certification to the Area Director of the OSHA office issuing the citation and identified above. This
abatement certification is to be provided by letter within 10 calendar days after each abatement date. Abatement
certification includes the date and method of abatement. If the citation indicates that the violation was corrected
during the inspection, no abatement certification is required for that item. The abatement certification letter must
be posted at the location where the violation appeared and the corrective action took place or employees must
otherwise be effectively informed about abatement activities. A sample abatement certification letter is enclosed
with this Citation. In addition, where the citation indicates that abatement documentation is necessary, evidence
of the purchase or repair of equipment, photographs or video, receipts, training records, etc., verifying that
abatement has occurred is required to be provided to the Area Director.
Employer Discrimination Unlawful – The law prohibits discrimination by an employer against an
Citation and Notification of Penalty Page 3 OSHA-2
employee for filing a complaint or for exercising any rights under this Act. An employee who believes that
he/she has been discriminated against may file a complaint no later than 30 days after the discrimination
occurred with the U.S. Department of Labor Area Office at the address shown above.
Employer Rights and Responsibilities – The enclosed booklet (OSHA 3000) outlines additional
employer rights and responsibilities and should be read in conjunction with this notification.
Notice to Employees – The law gives an employee or his/her representative the opportunity to object to any
abatement date set for a violation if he/she believes the date to be unreasonable. The contest must be mailed to
the U.S. Department of Labor Area Office at the address shown above and postmarked within 15 working days
(excluding weekends and Federal holidays) of the receipt by the employer of this Citation and Notification of
Penalty.
Inspection Activity Data – You should be aware that OSHA publishes information on its inspection and
citation activity on the Internet under the provisions of the Electronic Freedom of Information Act. The
information related to these alleged violations will be posted when our system indicates that you have received
this citation. You are encouraged to review the information concerning your establishment at www.osha.gov. If
you have any dispute with the accuracy of the information displayed, please contact this office.
Citation and Notification of Penalty Page 4 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
NOTICE TO EMPLOYEES OF INFORMAL CONFERENCE
An informal conference has been scheduled with OSHA to discuss the citation(s) issued on
12/15/2022. The conference will be held by telephone or
at the OSHA office located at 401
New Karner Road, Suite 300, Albany, NY 12205 on _________________ at
_________________. Employees and/or representatives of employees have a right to attend an
informal conference.
Citation and Notification of Penalty Page 5 OSHA-2
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET
Inspection Number: 1610874
Company Name: Amazon.com Services LLC – ALB1 Fulfillment Center
Inspection Site: 1835 U.S. 9, Castleton On Hudson, NY 12033
Issuance Date: 12/15/2022
List the specific method of correction for each item on this citation in this package that does not read “Corrected
During Inspection” and return to: U.S. Department of Labor – Occupational Safety and Health
Administration, 401 New Karner Road, Suite 300, Albany, NY 12205.
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
I certify that the information contained in this document is accurate and that the affected employees and their
representatives have been informed of the abatement.
________________________________ ________________________________
Signature Date
________________________________ ________________________________
Typed or Printed Name Title
NOTE: 29 USC 666(g) whoever knowingly makes any false statements, representation or certification in any application, record, plan or
other documents filed or required to be maintained pursuant to the Act shall, upon conviction, be punished by a fine of not more than
$10,000 or by imprisonment of not more than 6 months or both.
POSTING: A copy of completed Corrective Action Worksheet should be posted for employee review
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1610874
Inspection Date(s): 08/01/2022 - 12/15/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC – ALB1 Fulfillment Center
Inspection Site: 1835 U.S. 9, Castleton On Hudson, NY 12033
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 6 OSHA-2
Citation 1 Item 1 Type of Violation: Other-than-Serious
29 CFR 1904.4 (a): The employer did not record each work-related fatality, injury or illness case that resulted in the
general recording criteria on the OSHA Form 300 or equivalent:
At the Amazon ALB1 Fulfillment Center, Castleton on Hudson, NY, the employer did not record the following
workplace injuries or illnesses on the OSHA Form 300 or equivalent for the calendar year 2022:
a) On or about June 20, 2022, the employer failed to record a work-related injury that occurred on or about June 13,
2022. An employee working in the Outbound Dock felt pain in knee while performing work as a ship dock worker.
The employee's injury resulted in medical treatment beyond first aid and missed workdays.
b) On or about June 25, 2022, the employer failed to record a work-related injury that occurred on or about June 18,
2022. An employee working as a Packer rolled their left ankle due to an un-taped ergo mat resulting in an injury to
the employee's ankle. The employee's injury resulted in medical treatment beyond first aid, days away from work,
and restricted duty.
c) On or about July 1, 2022, the employer failed to record a work-related injury that occurred on or about June 24,
2022. An employee working in Inbound Stow felt a sudden pain in the right shoulder when lifting a heavy box of
kitty litter. The employee's injury resulted in restricted work and medical treatment beyond first aid.
d) On or about July 7, 2022, the employer failed to record a work-related injury that occurred on or about 6/30/22.
An employee was lifting an inflatable canoe while working in Pack Singles and felt pain in wrist which continued
when picking up another box. The injury resulted in days away from work.
e) On or about July 9, 2022, the employer failed to record a work-related injury that occurred on or about July 2,
2022. An employee working in the Ship Dock felt pinching pain in the lower back while lifting several pools back-
to-back. The employee's injury resulted in medical treatment beyond first aid.
f) On or about July 10, 2022, the employer failed to record a work-related injury that occurred on or about July 3,
2022. An employee was working Pack Singles where employee was packing, taping, and lifting boxes. Employee
felt pain in the right forearm that went to the thumb that got worse over the course of the shift. The employee's
injury resulted in medical treatment beyond first aid and restricted duty.
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1610874
Inspection Date(s): 08/01/2022 - 12/15/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC – ALB1 Fulfillment Center
Inspection Site: 1835 U.S. 9, Castleton On Hudson, NY 12033
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 7 OSHA-2
g) On or about July 12, 2022, the employer failed to record a work-related injury that occurred on or about July 5,
2022. An employee working in Pick felt a pop and injured their shoulder while reaching to pick an item. The
employee's injury resulted in restricted duty.
h) On or about July 25, 2022, the employer failed to record a work-related injury that occurred on or about July 18,
2022. An employee was working in Pick and gradually felt increasing pain in right shoulder. Injury resulted in days
away from work and medical treatment beyond first aid.
i) On or about July 29, 2022, the employer failed to record a work-related injury that occurred on or about July 23,
2022. An employee was working in Pack Singles when boxes fell from overhead, striking him in the chest, causing
him to drop a box on his foot. The employee's injury resulted in restricted duty.
j) On or about August 4, 2022, the employer failed to record a work-related injury that occurred on or about July 28,
2022. An employee felt pinching pain in shoulder while pulling carts. The employee's injury resulted in restricted
duty.
k) On or about August 5, 2022, the employer failed to record a work-related injury that occurred on or about July
29, 2022. An employee working in the Inbound Transship Area sustained a laceration to their right thumb caused by
a strap that popped and struck the employee's thumb. The injury resulted in medical treatment beyond first aid.
Date By Which Violation Must be Abated: December 27, 2022
Proposed Penalty: $2,072.00
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1610874
Inspection Date(s): 08/01/2022 - 12/15/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC – ALB1 Fulfillment Center
Inspection Site: 1835 U.S. 9, Castleton On Hudson, NY 12033
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 8 OSHA-2
Citation 1 Item 2 Type of Violation: Other-than-Serious
29 CFR 1904.7(b)(4): The employer did not correctly classify the following work-related injuries or illnesses on the
OSHA Form 300 or equivalent.
On or about August 1, 2022, the employer did not enter correctly the following work-related injuries or illnesses on
the OSHA Form 300 or equivalent for the calendar year 2022.
a) On or about July 26, 2022, an employee was struck by a mattress that fell on his right shoulder while working at
a slam station in Box on Demand (BOD). The employer did not record the days of restricted work after the injury.
Date By Which Violation Must be Abated: December 27, 2022
Proposed Penalty: $2,072.00
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1610874
Inspection Date(s): 08/01/2022 - 12/15/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC – ALB1 Fulfillment Center
Inspection Site: 1835 U.S. 9, Castleton On Hudson, NY 12033
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 9 OSHA-2
Citation 1 Item 3 Type of Violation: Other-than-Serious
29 CFR 1904.29(b)(3): The employer did not record the case on their OSHA form within seven calendar days of
receiving information that a recordable injury or illness has occurred:
At the Amazon ALB1 Fulfillment Center, Castleton on Hudson, NY, the employer failed to record the following
workplace injuries within seven calendar days of receiving information that the injury occurred:
a) On or about June 9, 2022, an employee working in Pack Singles sustained a recordable injury caused by lifting
heavy boxes from a tote. The employee was placed on restricted duty as a result of the injury. Amazon failed to
record the injury on their OSHA Form 300 within seven calendar days, on or about June 16, 2022.
b) On or about June 22, 2022, an employee working in the Ship Dock sustained an injury to their shoulder while
pulling a cage. The employee was placed on restricted duty as a result of the injury. Amazon failed to record the
injury on their OSHA Form 300 within seven calendar days, on or about June 29, 2022.
Date By Which Violation Must be Abated: December 27, 2022
Proposed Penalty: $2,072.00
______________________________
Rita Young, MS
Area Director
Citation and Notification of Penalty Page 10 OSHA-2
______________________________________________________________________________________________________________________
U.S. Department of Labor
Occupational Safety and Health Administration
401 New Karner Road, Suite 300
Albany, NY 12205
INVOICE /
DEBT COLLECTION NOTICE
Company Name: Amazon.com Services LLC – ALB1 Fulfillment Center
Inspection Site: 1835 U.S. 9, Castleton On Hudson, NY 12033
Issuance Date: 12/15/2022
Summary of Penalties for Inspection Number: 1610874
Citation 1 Item 1, Other-than-Serious
$2,072.00
Citation 1 Item 2, Other-than-Serious
$2,072.00
Citation 1 Item 3, Other-than-Serious
$2,072.00
TOTAL PROPOSED PENALTIES:
$6,216.00
To avoid additional charges, please remit payment promptly to this Area Office for the total amount of the
uncontested penalties summarized above. Make your check or money order payable to: "DOL-OSHA". Please
indicate OSHA's Inspection Number (indicated above) on the remittance. You can also make your payment
electronically at www.pay.gov. At the top of the pay.gov homepage, type “OSHA” in the Search field and select
Search. From the OSHA Penalty Payment Form search result, select Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
. You will be required to enter
your inspection number when making the payment. Payments can be made by credit card or Automated Clearing
House (ACH) using your banking information. Payments of $25,000 or more require a Transaction ID, and also
must be paid using ACH. If you require a Transaction ID, please contact the OSHA Debt Collection Team at (202)
693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or electronic
payment for less than the full amount due, and will cash the check or money order as if these restrictions or
conditions do not exist.
If a personal check is issued, it will be converted into an electronic fund transfer (EFT). This means that our bank
will copy your check and use the account information on it to electronically debit your account for the amount of
the check. The debit from your account will then usually occur within 24 hours and will be shown on your regular
account statement. You will not receive your original check back. The bank will destroy your original check, but
Citation and Notification of Penalty Page 11 OSHA-2
will keep a copy of it. If the EFT cannot be completed because of insufficient funds or closed account, the bank will
attempt to make the transfer up to two times.
Pursuant to the Debt Collection Act of 1982 (Public Law 97-365) and regulations of the U.S. Department of Labor
(29 CFR Part 20), the Occupational Safety and Health Administration is required to assess interest, delinquent
charges, and administrative costs for the collection of delinquent penalty debts for violations of the Occupational
Safety and Health Act.
Interest: Interest charges will be assessed at an annual rate determined by the Secretary of the Treasury on all
penalty debt amounts not paid within one month (30 calendar days) of the date on which the debt amount becomes
due and payable (penalty due date). The current interest rate is one percent (1%). Interest will accrue from the date
on which the penalty amounts (as proposed or adjusted) become a final order of the Occupational Safety and Health
Review Commission (that is, 15 working days from your receipt of the Citation and Notification of Penalty), unless
you file a notice of contest. Interest charges will be waived if the full amount owed is paid within 30 calendar days
of the final order.
Delinquent Charges:
A debt is considered delinquent if it has not been paid within one month (30 calendar days) of
the penalty due date or if a satisfactory payment arrangement has not been made. If the debt remains delinquent for
more than 90 calendar days, a delinquent charge of six percent (6%) per annum will be assessed accruing from the
date that the debt became delinquent.
Administrative Costs:
Agencies of the Department of Labor are required to assess additional charges for the
recovery of delinquent debts. These additional charges are administrative costs incurred by the Agency in its
attempt to collect an unpaid debt. Administrative costs will be assessed for demand letters sent in an attempt to
collect the unpaid debt.
_________________________________________
___________________________
Rita Young, MS
Date
Area Director
12/15/2022
U.S. Department of Labor
12/15/2022
Amazon.com Services LLC, dba Amazon Fulfillment Center BOI2
and its successors
5319 E Franklin Rd
Nampa, ID 83687
Dear Employer:
Enclosed you will find citations for violations of the Occupational Safety and Health Act of 1970 (the Act) which
may have accompanying proposed penalties. Also enclosed is a booklet entitled, “Employer Rights and
Responsibilities Following an OSHA Inspection”, (OSHA 3000-04R) revised 2018, which explains your rights
and responsibilities under the Act. If you have any questions about the enclosed citations and penalties, I would
welcome further discussions in person or by telephone. Please contact me at (208) 321-2960.
You will note on page 6 of the booklet that, for violations which you do not contest, you must (1) notify this
office promptly by letter that you have taken appropriate corrective action within the time set forth on the
citation; and (2) pay any penalties assessed. Please inform me of the abatement steps you have taken and of their
dates together with adequate supporting documentation; e.g., drawings or photographs of corrected conditions,
purchase/work orders related to abatement actions, air sampling results. This information will allow us to close
the case.
As indicated on page 3 of the booklet, you may request an informal conference with me during the 15-working-
day notice of contest period. During such an informal conference you may present any evidence or views which
you believe would support an adjustment to the citation or the penalty.
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of the citation. The running of this contest
period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete the attached notice at the bottom of this letter
and post it next to the Citations as soon as the time, date and the place of the informal conference have been
determined. Be sure to bring to the conference with you any and all supporting documentation of existing
conditions as well as of any abatement steps taken thus far. If conditions warrant, we can enter into an informal
settlement agreement which amicably resolves this matter without litigation or contest.
Occupational Safety and Health Administration
1387 S. Vinnell Way
Suite 218
Boise, ID 83709
You should be aware that OSHA publishes information on its inspection and citation activity on the Internet
under the provisions of Electronic Freedom of Information Act. The information related to these alleged
violations will be posted when our system indicates that you have received this citation. You are encouraged to
review the information concerning your establishment at www.osha.gov. If you have any dispute with the
accuracy of the information displayed, please contact this office.
Sincerely,
David G. Kearns
Area Director
Enclosures
Digitally signed by DAVID KEARNS
Date: 2022.12.15 10:28:16 -07'00'
Citation and Notification of Penalty Page 1 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
1387 S. Vinnell Way
Suite 218
Boise, ID 83709
Citation and Notification of Penalty
To:
Amazon.com Services LLC, dba Amazon Fulfillment
Center BOI2
and its successors
5319 E Franklin Rd
Nampa, ID 83687
Inspection Number: 1611861
Inspection Date(s): 08/01/2022 - 08/05/2022
Issuance Date: 12/15/2022
Inspection Site:
5295 E Franklin Rd
Nampa, ID 83687
The violation(s) described in this Citation and
Notification of Penalty is (are) alleged to have
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 (this Citation) describes violations of the Occupational Safety and
Health Act of 1970. The penalty(ies) listed herein is (are) based on these violations. You must abate the
violations referred to in this Citation by the dates listed and pay the penalties proposed, unless within 15 working
days (excluding weekends and Federal holidays) from your receipt of this Citation and Notification of Penalty
you either call to schedule an informal conference (see paragraph below) or you mail a notice of contest to
the U.S. Department of Labor Area Office at the address shown above. Please refer to the enclosed booklet
(OSHA 3000) which outlines your rights and responsibilities and which should be read in conjunction with this
form. Issuance of this Citation does not constitute a finding that a violation of the Act has occurred unless there
is a failure to contest as provided for in the Act or, if contested, unless this Citation is affirmed by the Review
Commission or a court.
Posting - The law requires that a copy of this Citation and Notification of Penalty be posted immediately in a
prominent place at or near the location of the violation(s) cited herein, or, if it is not practicable because of the
nature of the employer's operations, where it will be readily observable by all affected employees. This Citation
must remain posted until the violation(s) cited herein has (have) been abated, or for 3 working days (excluding
weekends and Federal holidays), whichever is longer.
Informal Conference - An informal conference is not required. However, if you wish to have such a
conference you may request one with the Area Director during the 15 working day contest period by calling
(208) 321-2960. During such an informal conference, you may present any evidence or views which you believe
would support an adjustment to the citation(s) and/or penalty(ies).
Citation and Notification of Penalty Page 2 OSHA-2
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of this Citation. The running of this
contest period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete, remove and post the Notice to Employees next
to this Citation and Notification of Penalty as soon as the time, date, and place of the informal conference have
been determined. 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 informal settlement
agreement which amicably resolves this matter without litigation or contest.
Right to Contest – You have the right to contest this Citation and Notification of Penalty. You may contest
all citation items or only individual items. You may also contest proposed penalties and/or abatement dates
without contesting the underlying violations. Unless you inform the Area Director in writing that you intend
to contest the citation(s) and/or proposed penalty(ies) within 15 working days after receipt, the citation(s)
and the proposed penalty(ies) will become a final order of the Occupational Safety and Health Review
Commission and may not be reviewed by any court or agency.
Penalty Payment – Penalties are due within 15 working days of receipt of this notification unless contested.
(See the enclosed booklet and the additional information provided related to the Debt Collection Act of 1982.)
Make your check or money order payable to “DOL-OSHA”. Please indicate the Inspection Number on the
remittance. You can also make your payment electronically at www.pay.gov. At the top of the pay.gov homepage,
type "OSHA" in the Search field and select Search. From OSHA Penalty Payment Form search result, select
Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
You will be required to enter your inspection number when making the payment. Payments can be made by
credit card or Automated Clearing House (ACH) using your banking information. Payments of $25,000 or more
require a Transaction ID, and also must be paid using ACH. If you require a Transaction ID, please contact the
OSHA Debt Collection Team at (202) 693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or
electronic payment for less than the full amount due, and will process the payments as if these restrictions or
conditions do not exist.
Notification of Corrective Action – For each violation which you do not contest, you must provide
abatement certification to the Area Director of the OSHA office issuing the citation and identified above. This
abatement certification is to be provided by letter within 10 calendar days after each abatement date. Abatement
certification includes the date and method of abatement. If the citation indicates that the violation was corrected
during the inspection, no abatement certification is required for that item. The abatement certification letter must
be posted at the location where the violation appeared and the corrective action took place or employees must
otherwise be effectively informed about abatement activities. A sample abatement certification letter is enclosed
with this Citation. In addition, where the citation indicates that abatement documentation is necessary, evidence
of the purchase or repair of equipment, photographs or video, receipts, training records, etc., verifying that
abatement has occurred is required to be provided to the Area Director.
Employer Discrimination Unlawful – The law prohibits discrimination by an employer against an
Citation and Notification of Penalty Page 3 OSHA-2
employee for filing a complaint or for exercising any rights under this Act. An employee who believes that
he/she has been discriminated against may file a complaint no later than 30 days after the discrimination
occurred with the U.S. Department of Labor Area Office at the address shown above.
Employer Rights and Responsibilities – The enclosed booklet (OSHA 3000) outlines additional
employer rights and responsibilities and should be read in conjunction with this notification.
Notice to Employees – The law gives an employee or his/her representative the opportunity to object to any
abatement date set for a violation if he/she believes the date to be unreasonable. The contest must be mailed to
the U.S. Department of Labor Area Office at the address shown above and postmarked within 15 working days
(excluding weekends and Federal holidays) of the receipt by the employer of this Citation and Notification of
Penalty.
Inspection Activity Data – You should be aware that OSHA publishes information on its inspection and
citation activity on the Internet under the provisions of the Electronic Freedom of Information Act. The
information related to these alleged violations will be posted when our system indicates that you have received
this citation. You are encouraged to review the information concerning your establishment at www.osha.gov. If
you have any dispute with the accuracy of the information displayed, please contact this office.
Citation and Notification of Penalty Page 4 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
NOTICE TO EMPLOYEES OF INFORMAL CONFERENCE
An informal conference has been scheduled with OSHA to discuss the citation(s) issued on
12/15/2022. The conference will be held by telephone or
at the OSHA office located at 1387 S.
Vinnell Way, Suite 218, Boise, ID 83709 on _________________ at _________________.
Employees and/or representatives of employees have a right to attend an informal conference.
Citation and Notification of Penalty Page 5 OSHA-2
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET
Inspection Number: 1611861
Company Name: Amazon.com Services LLC, dba Amazon Fulfillment Center BOI2
Inspection Site: 5295 E Franklin Rd, Nampa, ID 83687
Issuance Date: 12/15/2022
List the specific method of correction for each item on this citation in this package that does not read “Corrected
During Inspection” and return to: U.S. Department of Labor – Occupational Safety and Health
Administration, 1387 S. Vinnell Way, Suite 218, Boise, ID 83709.
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
I certify that the information contained in this document is accurate and that the affected employees and their
representatives have been informed of the abatement.
________________________________ ________________________________
Signature Date
________________________________ ________________________________
Typed or Printed Name Title
NOTE: 29 USC 666(g) whoever knowingly makes any false statements, representation or certification in any application, record, plan or
other documents filed or required to be maintained pursuant to the Act shall, upon conviction, be punished by a fine of not more than
$10,000 or by imprisonment of not more than 6 months or both.
POSTING: A copy of completed Corrective Action Worksheet should be posted for employee review
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1611861
Inspection Date(s): 08/01/2022 - 08/05/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC, dba Amazon Fulfillment Center BOI2
Inspection Site: 5295 E Franklin Rd, Nampa, ID 83687
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 6 OSHA-2
Citation 1 Item 1 Type of Violation: Other-than-Serious
29 CFR 1904.7(b)(4): The employer failed to enter the correct number of calendar days for a work-related injury on
the OSHA Form 300 or equivalent.
a) Case No. 119 (Stow) occurring on 6/10/2022, an employee injured their right hand after lifting a heavy item in
stow. The injury resulted in an on-job transfer or restriction that began on 6/24/2022. The injury recorded 25 work
restricted workdays even though there at least 38 restricted workdays.
In accordance with 29 CFR 1903.19(c), abatement certification is required for this violation (using the
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET).
Date By Which Violation Must be Abated: January 09, 2023
Proposed Penalty: $2,072.00
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1611861
Inspection Date(s): 08/01/2022 - 08/05/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC, dba Amazon Fulfillment Center BOI2
Inspection Site: 5295 E Franklin Rd, Nampa, ID 83687
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 7 OSHA-2
Citation 1 Item 2 Type of Violation: Other-than-Serious
29 CFR 1904.40(a):The employer did not provide an authorized government representative the records within the
four business hours.
On or about 8/1/2022, the employer failed to provide OSHA 301 Injury and Illness Incident Reports for injuries
and/or illnesses included in their 2022 calendar year OSHA 300 Log within four business hours. The company
provided incomplete records approximately nine hours after the initial request. Upon receipt, the missing OSHA
301s included OSHA 300 Log case numbers 26, 28, 29, 31-43, 45-78, 80-83, and 85-110. The violations included,
but were not limited to the following:
(a) Case No. 43 (AFE Pack Stations) occurring on 3/6/2022, an employee sustained an injury to the back after
lifting boxes at their pack station. The injury resulted in job transfer or restriction for 67 days.
(b) Case No. 59 (Station 4390) occurring on 3/28/2022, an employee sustained a wrist pain while lifting a tote with
items. The injury resulted in job transfer or restriction for 102 days.
(c) Case No. 61 (Pick Station 3337) occurring on 3/27/2022, an employee sustained a wrist sprain while picking
items from a lower pod. The injury resulted in job transfer or restriction for 125 days.
(d) Case No. 65 (AFE / Rebin Pack Stations) occurring on 3/28/2022, an employee sustained a back injury during
rebinning activities. The injury resulted in job transfer or restriction for 36 days.
(e) Case No. 67 (Stow Stations) occurring on 4/2/2022, an employee was stowing an item and felt pain in their left
thumb. The injury resulted in job transfer or restriction for 96 days.
(f) Case No. 72 (AFE1 Station 110-1) occurring on 4/6/2022, an employee injured their back while working in
AFE1 lifting heavy items all day. The injury resulted in job transfer or restriction for 69 days.
(g) Case No. 81 (Stow Station) occurring on 5/10/2022, an employee injured their right wrist while working in stow
after mishandling an empty tote/item. The injury resulted in job transfer or restriction for 82 days.
(h) Case No. 88 (Decant) occurring on 5/13/2022, an employee injured their left wrist picking up a case of items in
decant. The injury resulted in job transfer or restriction for 15 days.
(i) Case No. 93 (Pick ARSAW Station 2134) occurring on 5/24/2022, an employee felt pain to right wrist while
picking. The injury resulted in job transfer or restriction for 51 days.
(j) Case No. 100 (Pick Station) occurring on 6/1/2022, an employee sustained an injured finger from jamming into
an item while reaching into a bin. The injury resulted in job transfer or restriction for 59 days.
(k) Case No. 105 (Pick Station) occurring on 5/10/2022, an employee sustained wrist pain from picking items. The
injury resulted in job transfer or restriction for 15 days.
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1611861
Inspection Date(s): 08/01/2022 - 08/05/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC, dba Amazon Fulfillment Center BOI2
Inspection Site: 5295 E Franklin Rd, Nampa, ID 83687
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 8 OSHA-2
In accordance with 29 CFR 1903.19(c), abatement certification is required for this violation (using the
CERTIFICATION OF CORRECTIVE ATCION WORKSHEET).
NOTE: This inspection will remain open pending additional review and evaluation. Further citations may be issued.
Date By Which Violation Must be Abated: Corrected During Inspection
Proposed Penalty: $2,072.00
______________________________
David G. Kearns
Area Director
______________________________________________________________________________________________________________________
Digitally signed by DAVID
KEARNS
Date: 2022.12.15 10:29:03 -07'00'
Citation and Notification of Penalty Page 9 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
1387 S. Vinnell Way
Suite 218
Boise, ID 83709
INVOICE /
DEBT COLLECTION NOTICE
Company Name: Amazon.com Services LLC, dba Amazon Fulfillment Center BOI2
Inspection Site: 5295 E Franklin Rd, Nampa, ID 83687
Issuance Date: 12/15/2022
Summary of Penalties for Inspection Number: 1611861
Citation 1 Item 1, Other-than-Serious
$2,072.00
Citation 1 Item 2, Other-than-Serious
$2,072.00
TOTAL PROPOSED PENALTIES:
$4,144.00
To avoid additional charges, please remit payment promptly to this Area Office for the total amount of the
uncontested penalties summarized above. Make your check or money order payable to: "DOL-OSHA". Please
indicate OSHA's Inspection Number (indicated above) on the remittance. You can also make your payment
electronically at www.pay.gov. At the top of the pay.gov homepage, type “OSHA” in the Search field and select
Search. From the OSHA Penalty Payment Form search result, select Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
. You will be required to enter
your inspection number when making the payment. Payments can be made by credit card or Automated Clearing
House (ACH) using your banking information. Payments of $25,000 or more require a Transaction ID, and also
must be paid using ACH. If you require a Transaction ID, please contact the OSHA Debt Collection Team at (202)
693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or electronic
payment for less than the full amount due, and will cash the check or money order as if these restrictions or
conditions do not exist.
If a personal check is issued, it will be converted into an electronic fund transfer (EFT). This means that our bank
will copy your check and use the account information on it to electronically debit your account for the amount of
the check. The debit from your account will then usually occur within 24 hours and will be shown on your regular
account statement. You will not receive your original check back. The bank will destroy your original check, but
will keep a copy of it. If the EFT cannot be completed because of insufficient funds or closed account, the bank will
attempt to make the transfer up to two times.
Pursuant to the Debt Collection Act of 1982 (Public Law 97-365) and regulations of the U.S. Department of Labor
Citation and Notification of Penalty Page 10 OSHA-2
(29 CFR Part 20), the Occupational Safety and Health Administration is required to assess interest, delinquent
charges, and administrative costs for the collection of delinquent penalty debts for violations of the Occupational
Safety and Health Act.
Interest: Interest charges will be assessed at an annual rate determined by the Secretary of the Treasury on all
penalty debt amounts not paid within one month (30 calendar days) of the date on which the debt amount becomes
due and payable (penalty due date). The current interest rate is one percent (1%). Interest will accrue from the date
on which the penalty amounts (as proposed or adjusted) become a final order of the Occupational Safety and Health
Review Commission (that is, 15 working days from your receipt of the Citation and Notification of Penalty), unless
you file a notice of contest. Interest charges will be waived if the full amount owed is paid within 30 calendar days
of the final order.
Delinquent Charges: A debt is considered delinquent if it has not been paid within one month (30 calendar days) of
the penalty due date or if a satisfactory payment arrangement has not been made. If the debt remains delinquent for
more than 90 calendar days, a delinquent charge of six percent (6%) per annum will be assessed accruing from the
date that the debt became delinquent.
Administrative Costs: Agencies of the Department of Labor are required to assess additional charges for the
recovery of delinquent debts. These additional charges are administrative costs incurred by the Agency in its
attempt to collect an unpaid debt. Administrative costs will be assessed for demand letters sent in an attempt to
collect the unpaid debt.
_________________________________________
___________________________
David G. Kearns
Date
Area Director
Digitally signed by DAVID KEARNS
Date: 2022.12.15 10:29:36 -07'00'
U.S. Department of Labor
12/15/2022
Amazon.com Services LLC, dba DEN5 Amazon Sortation Center
and its successors
410 Terry Ave N
Seattle, WA 98109
Dear Employer:
Enclosed you will find citations for violations of the Occupational Safety and Health Act of 1970 (the Act) which
may have accompanying proposed penalties. Also enclosed is a booklet entitled, “Employer Rights and
Responsibilities Following an OSHA Inspection”, (OSHA 3000-04R) revised 2018, which explains your rights
and responsibilities under the Act. If you have any questions about the enclosed citations and penalties, I would
welcome further discussions in person or by telephone. Please contact me at (303) 844-5285.
You will note on page 6 of the booklet that, for violations which you do not contest, you must (1) notify this
office promptly by letter that you have taken appropriate corrective action within the time set forth on the
citation; and (2) pay any penalties assessed. Please inform me of the abatement steps you have taken and of their
dates together with adequate supporting documentation, e.g., drawings or photographs of corrected conditions,
purchase/work orders related to abatement actions, air sampling results. This information will allow us to close
the case.
As indicated on page 3 of the booklet, you may request an informal conference with me during the 15-working-
day notice of contest period. During such an informal conference you may present any evidence or views which
you believe would support an adjustment to the citation or the penalty.
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of the citation. The running of this contest
period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete the attached notice at the bottom of this letter
and post it next to the Citations as soon as the time, date and the place of the informal conference have been
determined. Be sure to bring to the conference with you any and all supporting documentation of existing
conditions as well as of any abatement steps taken thus far. If conditions warrant, we can enter into an informal
settlement agreement which amicably resolves this matter without litigation or contest.
Occupational Safety and Health Administration
1391 Speer Blvd, Suite 210
Denver, CO 80204
You should be aware that OSHA publishes information on its inspection and citation activity on the Internet
under the provisions of Electronic Freedom of Information Act. The information related to these alleged
violations will be posted when our system indicates that you have received this citation. You are encouraged to
review the information concerning your establishment at www.osha.gov. If you have any dispute with the
accuracy of the information displayed, please contact this office.
Sincerely,
Amanda Kupper
Area Director
Enclosures
Citation and Notification of Penalty Page 1 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
1391 Speer Blvd, Suite 210
Denver, CO 80204
Citation and Notification of Penalty
To:
Amazon.com Services LLC, dba DEN5 Amazon
Sortation Center
and its successors
410 Terry Ave N
Seattle, WA 98109
Inspection Number: 1611567
Inspection Date(s): 08/01/2022 - 10/19/2022
Issuance Date: 12/15/2022
Inspection Site:
19799 E. 36th Dr.
Aurora, CO 80011
The violation(s) described in this Citation and
Notification of Penalty is (are) alleged to have
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 (this Citation) describes violations of the Occupational Safety and
Health Act of 1970. The penalty(ies) listed herein is (are) based on these violations. You must abate the
violations referred to in this Citation by the dates listed and pay the penalties proposed, unless within 15 working
days (excluding weekends and Federal holidays) from your receipt of this Citation and Notification of Penalty
you either call to schedule an informal conference (see paragraph below) or you mail a notice of contest to
the U.S. Department of Labor Area Office at the address shown above. Please refer to the enclosed booklet
(OSHA 3000) which outlines your rights and responsibilities and which should be read in conjunction with this
form. Issuance of this Citation does not constitute a finding that a violation of the Act has occurred unless there
is a failure to contest as provided for in the Act or, if contested, unless this Citation is affirmed by the Review
Commission or a court.
Posting - The law requires that a copy of this Citation and Notification of Penalty be posted immediately in a
prominent place at or near the location of the violation(s) cited herein, or, if it is not practicable because of the
nature of the employer's operations, where it will be readily observable by all affected employees. This Citation
must remain posted until the violation(s) cited herein has (have) been abated, or for 3 working days (excluding
weekends and Federal holidays), whichever is longer.
Informal Conference - An informal conference is not required. However, if you wish to have such a
conference you may request one with the Area Director during the 15 working day contest period by calling
(303) 844-5285. During such an informal conference, you may present any evidence or views which you believe
would support an adjustment to the citation(s) and/or penalty(ies).
Citation and Notification of Penalty Page 2 OSHA-2
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of this Citation. The running of this
contest period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete, remove and post the Notice to Employees next
to this Citation and Notification of Penalty as soon as the time, date, and place of the informal conference have
been determined. 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 informal settlement
agreement which amicably resolves this matter without litigation or contest.
Right to Contest – You have the right to contest this Citation and Notification of Penalty. You may contest
all citation items or only individual items. You may also contest proposed penalties and/or abatement dates
without contesting the underlying violations. Unless you inform the Area Director in writing that you intend
to contest the citation(s) and/or proposed penalty(ies) within 15 working days after receipt, the citation(s)
and the proposed penalty(ies) will become a final order of the Occupational Safety and Health Review
Commission and may not be reviewed by any court or agency.
Penalty Payment – Penalties are due within 15 working days of receipt of this notification unless contested.
(See the enclosed booklet and the additional information provided related to the Debt Collection Act of 1982.)
Make your check or money order payable to “DOL-OSHA”. Please indicate the Inspection Number on the
remittance. You can also make your payment electronically at www.pay.gov. At the top of the pay.gov homepage,
type "OSHA" in the Search field and select Search. From OSHA Penalty Payment Form search result, select
Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
You will be required to enter your inspection number when making the payment. Payments can be made by
credit card or Automated Clearing House (ACH) using your banking information. Payments of $25,000 or more
require a Transaction ID, and also must be paid using ACH. If you require a Transaction ID, please contact the
OSHA Debt Collection Team at (202) 693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or
electronic payment for less than the full amount due, and will process the payments as if these restrictions or
conditions do not exist.
Notification of Corrective Action – For each violation which you do not contest, you must provide
abatement certification to the Area Director of the OSHA office issuing the citation and identified above. This
abatement certification is to be provided by letter within 10 calendar days after each abatement date. Abatement
certification includes the date and method of abatement. If the citation indicates that the violation was corrected
during the inspection, no abatement certification is required for that item. The abatement certification letter must
be posted at the location where the violation appeared and the corrective action took place or employees must
otherwise be effectively informed about abatement activities. A sample abatement certification letter is enclosed
with this Citation. In addition, where the citation indicates that abatement documentation is necessary, evidence
of the purchase or repair of equipment, photographs or video, receipts, training records, etc., verifying that
abatement has occurred is required to be provided to the Area Director.
Citation and Notification of Penalty Page 3 OSHA-2
Employer Discrimination Unlawful – The law prohibits discrimination by an employer against an
employee for filing a complaint or for exercising any rights under this Act. An employee who believes that
he/she has been discriminated against may file a complaint no later than 30 days after the discrimination
occurred with the U.S. Department of Labor Area Office at the address shown above.
Employer Rights and Responsibilities – The enclosed booklet (OSHA 3000) outlines additional
employer rights and responsibilities and should be read in conjunction with this notification.
Notice to Employees – The law gives an employee or his/her representative the opportunity to object to any
abatement date set for a violation if he/she believes the date to be unreasonable. The contest must be mailed to
the U.S. Department of Labor Area Office at the address shown above and postmarked within 15 working days
(excluding weekends and Federal holidays) of the receipt by the employer of this Citation and Notification of
Penalty.
Inspection Activity Data – You should be aware that OSHA publishes information on its inspection and
citation activity on the Internet under the provisions of the Electronic Freedom of Information Act. The
information related to these alleged violations will be posted when our system indicates that you have received
this citation. You are encouraged to review the information concerning your establishment at www.osha.gov. If
you have any dispute with the accuracy of the information displayed, please contact this office.
Citation and Notification of Penalty Page 4 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
NOTICE TO EMPLOYEES OF INFORMAL CONFERENCE
An informal conference has been scheduled with OSHA to discuss the citation(s) issued on
12/15/2022. The conference will be held by telephone or
at the OSHA office located at 1391
Speer Blvd, Suite 210, Denver, CO 80204 on _________________ at _________________.
Employees and/or representatives of employees have a right to attend an informal conference.
Citation and Notification of Penalty Page 5 OSHA-2
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET
Inspection Number: 1611567
Company Name: Amazon.com Services LLC, dba DEN5 Amazon Sortation Center
Inspection Site: 19799 E. 36th Dr., Aurora, CO 80011
Issuance Date: 12/15/2022
List the specific method of correction for each item on this citation in this package that does not read “Corrected
During Inspection” and return to: U.S. Department of Labor – Occupational Safety and Health
Administration, 1391 Speer Blvd, Suite 210, Denver, CO 80204.
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
I certify that the information contained in this document is accurate and that the affected employees and their
representatives have been informed of the abatement.
________________________________ ________________________________
Signature Date
________________________________ ________________________________
Typed or Printed Name Title
NOTE: 29 USC 666(g) whoever knowingly makes any false statements, representation or certification in any application, record, plan or
other documents filed or required to be maintained pursuant to the Act shall, upon conviction, be punished by a fine of not more than
$10,000 or by imprisonment of not more than 6 months or both.
POSTING: A copy of completed Corrective Action Worksheet should be posted for employee review
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1611567
Inspection Date(s): 08/01/2022 - 10/19/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC, dba DEN5 Amazon Sortation Center
Inspection Site: 19799 E. 36th Dr., Aurora, CO 80011
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 6 OSHA-2
Citation 1 Item 1 Type of Violation: Other-than-Serious
29 CFR 1904.4(a): The employer did not record each work-related fatality, injury or illness case that resulted in the
general recording criteria on the OSHA Form 300 or equivalent:
a) Amazon.com Services LLC dba DEN5 Amazon Sortation Center, 19799 E. 36th Dr., Aurora, CO 80011: On or about
August 1, 2022, and at times prior, the employer did not record each workplace injury or illness on the OSHA Form 300
or equivalent for the calendar year 2022. Violative instances included but were not limited to:
1) Employee 1 (case # DEN5-22-486020d8) injured their left shoulder while at work on June 30, 2022. They were
working Fluid Unload and felt a pull in their shoulder. AmCare follow up noted they were working in Amazon Robotics
("AR") and iCare said "stay away from pallet jacks and unloading - sent to scan on the NW and send them upstairs if she
experiences any issues." This case was not recorded on the 2022 OSHA 300 Log and Amazon documented zero days of
restricted work.
2) Employee 2 (case # DEN5-22-4aefb586) reported pain in their right shoulder starting on July 22, 2022, after working
as a Water Spider and lifting packages repetitively over a high shuttle lip in AR Container build. They called AmCare
from home on July 22, 2022, and were given a prescription for a muscle relaxer. They reported the injury on July 27,
2022, because continued work as a Water Spider and container building under the mezzanine were aggravating their
shoulder pain. The iCare log indicated they were placed on the west side and moved to AR for a few days when they
were injured. This case was not recorded on the 2022 OSHA 300 Log and Amazon documented no days of restricted
work and no prescribed medications.
3) Employee 3 (case # DEN5-22-c8b49c70) injured their right elbow at work on July 26, 2022, while consolidating
partial pallets into shuttles. The iCare log indicated they were moved to AR Container Build and were also moved to AR
for a few days when they were injured. This case was not recorded on the 2022 OSHA 300 Log and Amazon documented
no days of restricted work.
4) Employee 4 (case # DEN5-22-ba153cbf) injured their right ankle on July 26, 2022, when they started feeling pain
during work as a Water Spider. The Austin log noted they were sent to AR Inducting, and iCare also noted worker "sent to
AR east." This case was not recorded on the 2022 OSHA 300 Log and Amazon documented no days of restricted work.
A
batement Note: Abatement certification is required for this item (see enclosed "Certification of Corrective Action
Worksheet").
Date By Which Violation Must be Abated: March 20, 2023
Proposed Penalty: $2,072.00
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1611567
Inspection Date(s): 08/01/2022 - 10/19/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC, dba DEN5 Amazon Sortation Center
Inspection Site: 19799 E. 36th Dr., Aurora, CO 80011
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 7 OSHA-2
Citation 1 Item 2 Type of Violation: Other-than-Serious
29 CFR 1904.29(b)(3): Each recordable injury or illness was not entered on the OSHA 300 Log within seven (7)
calendar days of receiving information that a recordable injury or illness occurred:
a) Amazon.com Services LLC dba DEN5 Amazon Sortation Center, 19799 E. 36th Dr., Aurora, CO 80011: On or
about August 1, 2022, and at times prior, the employer did not correctly document the following workplace injuries
on the OSHA Form 300 or its equivalent for the calendar year 2022 withing seven (7) calendar days of receiving
information of a recordable injury or illness occurrence. Violative instances included but were not limited to:
1) Employee 5 (case # DEN5-22-d4487207) injured their right leg on July 8, 2022, when they were working Fluid
Load and dropped a package on their shin. iCare alluded to work restrictions prior to being sent offsite and the
worker was assigned to be limited to loading prior to being sent offsite for care. However, the first day away from
work recorded on the OSHA 300 Log was July 27, 2022. The worker was not listed on the original OSHA 300 Log
provided by Amazon in August 2022. The second OSHA 300 Log provided by Amazon during the October 2022
onsite visit listed 17 days away from work and zero days restricted/transfer work. The third OSHA 300 Log
provided by Amazon in November 2022, it listed 17 days away from work and 89 days restricted/transfer work.
Abatement Note: Abatement certification is required for this item (see enclosed "Certification of Corrective Action
Worksheet").
Date By Which Violation Must be Abated: March 20, 2023
Proposed Penalty: $2,072.00
______________________________
Amanda Kupper
Area Director
Citation and Notification of Penalty Page 8 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
1391 Speer Blvd, Suite 210
Denver, CO 80204
INVOICE /
DEBT COLLECTION NOTICE
Company Name: Amazon.com Services LLC, dba DEN5 Amazon Sortation Center
Inspection Site: 19799 E. 36th Dr., Aurora, CO 80011
Issuance Date: 12/15/2022
Summary of Penalties for Inspection Number: 1611567
Citation 2 Item 1, Other-than-Serious
$2,072.00
Citation 2 Item 2, Other-than-Serious
$2,072.00
TOTAL PROPOSED PENALTIES:
$4,144.00
To avoid additional charges, please remit payment promptly to this Area Office for the total amount of the
uncontested penalties summarized above. Make your check or money order payable to: "DOL-OSHA". Please
indicate OSHA's Inspection Number (indicated above) on the remittance. You can also make your payment
electronically at www.pay.gov. At the top of the pay.gov homepage, type “OSHA” in the Search field and select
Search. From the OSHA Penalty Payment Form search result, select Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
. You will be required to enter
your inspection number when making the payment. Payments can be made by credit card or Automated Clearing
House (ACH) using your banking information. Payments of $25,000 or more require a Transaction ID, and also
must be paid using ACH. If you require a Transaction ID, please contact the OSHA Debt Collection Team at (202)
693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or electronic
payment for less than the full amount due, and will cash the check or money order as if these restrictions or
conditions do not exist.
If a personal check is issued, it will be converted into an electronic fund transfer (EFT). This means that our bank
will copy your check and use the account information on it to electronically debit your account for the amount of
the check. The debit from your account will then usually occur within 24 hours and will be shown on your regular
account statement. You will not receive your original check back. The bank will destroy your original check, but
will keep a copy of it. If the EFT cannot be completed because of insufficient funds or closed account, the bank will
attempt to make the transfer up to two times.
Pursuant to the Debt Collection Act of 1982 (Public Law 97-365) and regulations of the U.S. Department of Labor
(29 CFR Part 20), the Occupational Safety and Health Administration is required to assess interest, delinquent
Citation and Notification of Penalty Page 9 OSHA-2
charges, and administrative costs for the collection of delinquent penalty debts for violations of the Occupational
Safety and Health Act.
Interest: Interest charges will be assessed at an annual rate determined by the Secretary of the Treasury on all
penalty debt amounts not paid within one month (30 calendar days) of the date on which the debt amount becomes
due and payable (penalty due date). The current interest rate is one percent (1%). Interest will accrue from the date
on which the penalty amounts (as proposed or adjusted) become a final order of the Occupational Safety and Health
Review Commission (that is, 15 working days from your receipt of the Citation and Notification of Penalty), unless
you file a notice of contest. Interest charges will be waived if the full amount owed is paid within 30 calendar days
of the final order.
Delinquent Charges:
A debt is considered delinquent if it has not been paid within one month (30 calendar days) of
the penalty due date or if a satisfactory payment arrangement has not been made. If the debt remains delinquent for
more than 90 calendar days, a delinquent charge of six percent (6%) per annum will be assessed accruing from the
date that the debt became delinquent.
Administrative Costs:
Agencies of the Department of Labor are required to assess additional charges for the
recovery of delinquent debts. These additional charges are administrative costs incurred by the Agency in its
attempt to collect an unpaid debt. Administrative costs will be assessed for demand letters sent in an attempt to
collect the unpaid debt.
_________________________________________
___________________________
Amanda Kupper
Date
Area Director
December 15, 2022
U.S. Department of Labor
12/15/2022
Amazon.com Services LLC, dba DYO1
and its successors
500 Hudson Valley Avenue
New Windsor, NY 12553
Dear Employer:
Enclosed you will find citations for violations of the Occupational Safety and Health Act of 1970 (the Act) which
may have accompanying proposed penalties. Also enclosed is a booklet entitled, “Employer Rights and
Responsibilities Following an OSHA Inspection”, (OSHA 3000-04R) revised 2018, which explains your rights
and responsibilities under the Act. If you have any questions about the enclosed citations and penalties, I would
welcome further discussions in person or by telephone. Please contact me at (518) 464-4338.
You will note on page 6 of the booklet that, for violations which you do not contest, you must (1) notify this
office promptly by letter that you have taken appropriate corrective action within the time set forth on the
citation; and (2) pay any penalties assessed. Please inform me of the abatement steps you have taken and of their
dates together with adequate supporting documentation; e.g., drawings or photographs of corrected conditions,
purchase/work orders related to abatement actions, air sampling results. This information will allow us to close
the case.
As indicated on page 3 of the booklet, you may request an informal conference with me during the 15-working-
day notice of contest period. During such an informal conference you may present any evidence or views which
you believe would support an adjustment to the citation or the penalty.
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of the citation. The running of this contest
period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete the attached notice at the bottom of this letter
and post it next to the Citations as soon as the time, date and the place of the informal conference have been
determined. Be sure to bring to the conference with you any and all supporting documentation of existing
conditions as well as of any abatement steps taken thus far. If conditions warrant, we can enter into an informal
settlement agreement which amicably resolves this matter without litigation or contest.
Occupational Safety and Health Administration
401 New Karner Road, Suite 300
Albany, NY 12205
You should be aware that OSHA publishes information on its inspection and citation activity on the Internet
under the provisions of Electronic Freedom of Information Act. The information related to these alleged
violations will be posted when our system indicates that you have received this citation. You are encouraged to
review the information concerning your establishment at www.osha.gov. If you have any dispute with the
accuracy of the information displayed, please contact this office.
Sincerely,
Rita Young, MS
Area Director
Enclosures
Citation and Notification of Penalty Page 1 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
401 New Karner Road, Suite 300
Albany, NY 12205
Citation and Notification of Penalty
To:
Amazon.com Services LLC, dba DYO1
and its successors
500 Hudson Valley Avenue
New Windsor, NY 12553
Inspection Number: 1607234
Inspection Date(s): 07/18/2022 – 12/15/2022
Issuance Date: 12/15/2022
Inspection Site:
500 Hudson Valley Avenue
New Windsor, NY 12553
The violation(s) described in this Citation and
Notification of Penalty is (are) alleged to have
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 (this Citation) describes violations of the Occupational Safety and
Health Act of 1970. The penalty(ies) listed herein is (are) based on these violations. You must abate the
violations referred to in this Citation by the dates listed and pay the penalties proposed, unless within 15 working
days (excluding weekends and Federal holidays) from your receipt of this Citation and Notification of Penalty
you either call to schedule an informal conference (see paragraph below) or you mail a notice of contest to
the U.S. Department of Labor Area Office at the address shown above. Please refer to the enclosed booklet
(OSHA 3000) which outlines your rights and responsibilities and which should be read in conjunction with this
form. Issuance of this Citation does not constitute a finding that a violation of the Act has occurred unless there
is a failure to contest as provided for in the Act or, if contested, unless this Citation is affirmed by the Review
Commission or a court.
Posting - The law requires that a copy of this Citation and Notification of Penalty be posted immediately in a
prominent place at or near the location of the violation(s) cited herein, or, if it is not practicable because of the
nature of the employer's operations, where it will be readily observable by all affected employees. This Citation
must remain posted until the violation(s) cited herein has (have) been abated, or for 3 working days (excluding
weekends and Federal holidays), whichever is longer.
Informal Conference - An informal conference is not required. However, if you wish to have such a
conference you may request one with the Area Director during the 15 working day contest period by calling
(518) 464-4338. During such an informal conference, you may present any evidence or views which you believe
would support an adjustment to the citation(s) and/or penalty(ies).
Citation and Notification of Penalty Page 2 OSHA-2
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of this Citation. The running of this
contest period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete, remove and post the Notice to Employees next
to this Citation and Notification of Penalty as soon as the time, date, and place of the informal conference have
been determined. 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 informal settlement
agreement which amicably resolves this matter without litigation or contest.
Right to Contest – You have the right to contest this Citation and Notification of Penalty. You may contest
all citation items or only individual items. You may also contest proposed penalties and/or abatement dates
without contesting the underlying violations. Unless you inform the Area Director in writing that you intend
to contest the citation(s) and/or proposed penalty(ies) within 15 working days after receipt, the citation(s)
and the proposed penalty(ies) will become a final order of the Occupational Safety and Health Review
Commission and may not be reviewed by any court or agency.
Penalty Payment – Penalties are due within 15 working days of receipt of this notification unless contested.
(See the enclosed booklet and the additional information provided related to the Debt Collection Act of 1982.)
Make your check or money order payable to “DOL-OSHA”. Please indicate the Inspection Number on the
remittance. You can also make your payment electronically at www.pay.gov. At the top of the pay.gov homepage,
type "OSHA" in the Search field and select Search. From OSHA Penalty Payment Form search result, select
Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
You will be required to enter your inspection number when making the payment. Payments can be made by
credit card or Automated Clearing House (ACH) using your banking information. Payments of $25,000 or more
require a Transaction ID, and also must be paid using ACH. If you require a Transaction ID, please contact the
OSHA Debt Collection Team at (202) 693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or
electronic payment for less than the full amount due, and will process the payments as if these restrictions or
conditions do not exist.
Notification of Corrective Action – For each violation which you do not contest, you must provide
abatement certification to the Area Director of the OSHA office issuing the citation and identified above. This
abatement certification is to be provided by letter within 10 calendar days after each abatement date. Abatement
certification includes the date and method of abatement. If the citation indicates that the violation was corrected
during the inspection, no abatement certification is required for that item. The abatement certification letter must
be posted at the location where the violation appeared and the corrective action took place or employees must
otherwise be effectively informed about abatement activities. A sample abatement certification letter is enclosed
with this Citation. In addition, where the citation indicates that abatement documentation is necessary, evidence
of the purchase or repair of equipment, photographs or video, receipts, training records, etc., verifying that
abatement has occurred is required to be provided to the Area Director.
Employer Discrimination Unlawful – The law prohibits discrimination by an employer against an
Citation and Notification of Penalty Page 3 OSHA-2
employee for filing a complaint or for exercising any rights under this Act. An employee who believes that
he/she has been discriminated against may file a complaint no later than 30 days after the discrimination
occurred with the U.S. Department of Labor Area Office at the address shown above.
Employer Rights and Responsibilities – The enclosed booklet (OSHA 3000) outlines additional
employer rights and responsibilities and should be read in conjunction with this notification.
Notice to Employees – The law gives an employee or his/her representative the opportunity to object to any
abatement date set for a violation if he/she believes the date to be unreasonable. The contest must be mailed to
the U.S. Department of Labor Area Office at the address shown above and postmarked within 15 working days
(excluding weekends and Federal holidays) of the receipt by the employer of this Citation and Notification of
Penalty.
Inspection Activity Data – You should be aware that OSHA publishes information on its inspection and
citation activity on the Internet under the provisions of the Electronic Freedom of Information Act. The
information related to these alleged violations will be posted when our system indicates that you have received
this citation. You are encouraged to review the information concerning your establishment at www.osha.gov. If
you have any dispute with the accuracy of the information displayed, please contact this office.
Citation and Notification of Penalty Page 4 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
NOTICE TO EMPLOYEES OF INFORMAL CONFERENCE
An informal conference has been scheduled with OSHA to discuss the citation(s) issued on
12/15/2022. The conference will be held by telephone or
at the OSHA office located at 401
New Karner Road, Suite 300, Albany, NY 12205 on _________________ at
_________________. Employees and/or representatives of employees have a right to attend an
informal conference.
Citation and Notification of Penalty Page 5 OSHA-2
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET
Inspection Number: 1607234
Company Name: Amazon.com Services LLC, dba DYO1
Inspection Site: 500 Hudson Valley Avenue, New Windsor, NY 12553
Issuance Date: 12/15/2022
List the specific method of correction for each item on this citation in this package that does not read “Corrected
During Inspection” and return to: U.S. Department of Labor – Occupational Safety and Health
Administration, 401 New Karner Road, Suite 300, Albany, NY 12205.
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
I certify that the information contained in this document is accurate and that the affected employees and their
representatives have been informed of the abatement.
________________________________ ________________________________
Signature Date
________________________________ ________________________________
Typed or Printed Name Title
NOTE: 29 USC 666(g) whoever knowingly makes any false statements, representation or certification in any application, record, plan or
other documents filed or required to be maintained pursuant to the Act shall, upon conviction, be punished by a fine of not more than
$10,000 or by imprisonment of not more than 6 months or both.
POSTING: A copy of completed Corrective Action Worksheet should be posted for employee review
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1607234
Inspection Date(s): 07/18/2022 - 12/15/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC, dba DYO1
Inspection Site: 500 Hudson Valley Avenue, New Windsor, NY 12553
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 6 OSHA-2
Citation 1 Item 1 Type of Violation: Other-than-Serious
29 CFR 1904.29(b)(3): The employer did not enter each recordable injury or illness on the OSHA 300 Log and 301
Incident Report within seven (7) calendar days of receiving information that a recordable injury or illness has
occurred:
At the Amazon DYO1 Delivery Center, New Windsor, NY, the employer failed to record the following workplace
injuries within seven calendar days of receiving information that the injury occurred:
a) On or about July 30, 2022, an employee working in Pick to Buffer suffered a work-related back injury resulting
in multiple days away from work. The employer did not record the injury on the OSHA 300 log for calendar year
2022 within 7 days of receiving information that the injury was recordable.
Date By Which Violation Must be Abated: Corrected During Inspection
Proposed Penalty: $2,072.00
______________________________
Rita Young, MS
Area Director
______________________________________________________________________________________________________________________
Citation and Notification of Penalty Page 7 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
401 New Karner Road, Suite 300
Albany, NY 12205
INVOICE /
DEBT COLLECTION NOTICE
Company Name: Amazon.com Services LLC, dba DYO1
Inspection Site: 500 Hudson Valley Avenue, New Windsor, NY 12553
Issuance Date: 12/15/2022
Summary of Penalties for Inspection Number: 1607234
Citation 1 Item 1, Other-than-Serious
$2,072.00
TOTAL PROPOSED PENALTIES:
$2,072.00
To avoid additional charges, please remit payment promptly to this Area Office for the total amount of the
uncontested penalties summarized above. Make your check or money order payable to: "DOL-OSHA". Please
indicate OSHA's Inspection Number (indicated above) on the remittance. You can also make your payment
electronically at www.pay.gov. At the top of the pay.gov homepage, type “OSHA” in the Search field and select
Search. From the OSHA Penalty Payment Form search result, select Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334. You will be required to enter
your inspection number when making the payment. Payments can be made by credit card or Automated Clearing
House (ACH) using your banking information. Payments of $25,000 or more require a Transaction ID, and also
must be paid using ACH. If you require a Transaction ID, please contact the OSHA Debt Collection Team at (202)
693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or electronic
payment for less than the full amount due, and will cash the check or money order as if these restrictions or
conditions do not exist.
If a personal check is issued, it will be converted into an electronic fund transfer (EFT). This means that our bank
will copy your check and use the account information on it to electronically debit your account for the amount of
the check. The debit from your account will then usually occur within 24 hours and will be shown on your regular
account statement. You will not receive your original check back. The bank will destroy your original check, but
will keep a copy of it. If the EFT cannot be completed because of insufficient funds or closed account, the bank will
attempt to make the transfer up to two times.
Pursuant to the Debt Collection Act of 1982 (Public Law 97-365) and regulations of the U.S. Department of Labor
(29 CFR Part 20), the Occupational Safety and Health Administration is required to assess interest, delinquent
charges, and administrative costs for the collection of delinquent penalty debts for violations of the Occupational
Citation and Notification of Penalty Page 8 OSHA-2
Safety and Health Act.
Interest: Interest charges will be assessed at an annual rate determined by the Secretary of the Treasury on all
penalty debt amounts not paid within one month (30 calendar days) of the date on which the debt amount becomes
due and payable (penalty due date). The current interest rate is one percent (1%). Interest will accrue from the date
on which the penalty amounts (as proposed or adjusted) become a final order of the Occupational Safety and Health
Review Commission (that is, 15 working days from your receipt of the Citation and Notification of Penalty), unless
you file a notice of contest. Interest charges will be waived if the full amount owed is paid within 30 calendar days
of the final order.
Delinquent Charges: A debt is considered delinquent if it has not been paid within one month (30 calendar days) of
the penalty due date or if a satisfactory payment arrangement has not been made. If the debt remains delinquent for
more than 90 calendar days, a delinquent charge of six percent (6%) per annum will be assessed accruing from the
date that the debt became delinquent.
Administrative Costs: Agencies of the Department of Labor are required to assess additional charges for the
recovery of delinquent debts. These additional charges are administrative costs incurred by the Agency in its
attempt to collect an unpaid debt. Administrative costs will be assessed for demand letters sent in an attempt to
collect the unpaid debt.
_________________________________________
___________________________
Rita Young, MS
Date
Area Director
12/15/2022
U.S. Department of Labor
12/15/2022
Amazon.com Services LLC-MCO2
and its successors
2600 N Normandy Blvd.
Deltona, FL 32725
Dear Employer:
Enclosed you will find citations for violations of the Occupational Safety and Health Act of 1970 (the Act) which
may have accompanying proposed penalties. Also enclosed is a booklet entitled, “Employer Rights and
Responsibilities Following an OSHA Inspection”, (OSHA 3000-04R) revised 2018, which explains your rights
and responsibilities under the Act. If you have any questions about the enclosed citations and penalties, I would
welcome further discussions in person or by telephone. Please contact me at (904) 232-2895.
You will note on page 6 of the booklet that, for violations which you do not contest, you must (1) notify this
office promptly by letter that you have taken appropriate corrective action within the time set forth on the
citation; and (2) pay any penalties assessed. Please inform me of the abatement steps you have taken and of their
dates together with adequate supporting documentation; e.g., drawings or photographs of corrected conditions,
purchase/work orders related to abatement actions, air sampling results. This information will allow us to close
the case.
As indicated on page 3 of the booklet, you may request an informal conference with me during the 15-working-
day notice of contest period. During such an informal conference you may present any evidence or views which
you believe would support an adjustment to the citation or the penalty.
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of the citation. The running of this contest
period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete the attached notice at the bottom of this letter
and post it next to the Citations as soon as the time, date and the place of the informal conference have been
determined. Be sure to bring to the conference with you any and all supporting documentation of existing
conditions as well as of any abatement steps taken thus far. If conditions warrant, we can enter into an informal
settlement agreement which amicably resolves this matter without litigation or contest.
Occupational Safety and Health Administration
1851 Executive Center Drive
Suite 227
Jacksonville, FL 32207
You should be aware that OSHA publishes information on its inspection and citation activity on the Internet
under the provisions of Electronic Freedom of Information Act. The information related to these alleged
violations will be posted when our system indicates that you have received this citation. You are encouraged to
review the information concerning your establishment at www.osha.gov. If you have any dispute with the
accuracy of the information displayed, please contact this office.
Sincerely,
David Tisdale
Area Director
Enclosures
DAVID
TISDALE
Digitally signed by
DAVID TISDALE
Date: 2022.12.15
15:20:14 -05'00'
Citation and Notification of Penalty Page 1 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
1851 Executive Center Drive
Suite 227
Jacksonville, FL 32207
Citation and Notification of Penalty
To:
Amazon.com Services LLC-MCO2
and its successors
2600 N Normandy Blvd.
Deltona, FL 32725
Inspection Number: 1608788
Inspection Date(s): 07/18/2022 - 07/22/2022
Issuance Date: 12/15/2022
Inspection Site:
2600 N Normandy Blvd.
Deltona, FL 32725
The violation(s) described in this Citation and
Notification of Penalty is (are) alleged to have
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 (this Citation) describes violations of the Occupational Safety and
Health Act of 1970. The penalty(ies) listed herein is (are) based on these violations. You must abate the
violations referred to in this Citation by the dates listed and pay the penalties proposed, unless within 15 working
days (excluding weekends and Federal holidays) from your receipt of this Citation and Notification of Penalty
you either call to schedule an informal conference (see paragraph below) or you mail a notice of contest to
the U.S. Department of Labor Area Office at the address shown above. Please refer to the enclosed booklet
(OSHA 3000) which outlines your rights and responsibilities and which should be read in conjunction with this
form. Issuance of this Citation does not constitute a finding that a violation of the Act has occurred unless there
is a failure to contest as provided for in the Act or, if contested, unless this Citation is affirmed by the Review
Commission or a court.
Posting - The law requires that a copy of this Citation and Notification of Penalty be posted immediately in a
prominent place at or near the location of the violation(s) cited herein, or, if it is not practicable because of the
nature of the employer's operations, where it will be readily observable by all affected employees. This Citation
must remain posted until the violation(s) cited herein has (have) been abated, or for 3 working days (excluding
weekends and Federal holidays), whichever is longer.
Informal Conference - An informal conference is not required. However, if you wish to have such a
conference you may request one with the Area Director during the 15 working day contest period by calling
(904) 232-2895. During such an informal conference, you may present any evidence or views which you believe
would support an adjustment to the citation(s) and/or penalty(ies).
Citation and Notification of Penalty Page 2 OSHA-2
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of this Citation. The running of this
contest period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete, remove and post the Notice to Employees next
to this Citation and Notification of Penalty as soon as the time, date, and place of the informal conference have
been determined. 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 informal settlement
agreement which amicably resolves this matter without litigation or contest.
Right to Contest – You have the right to contest this Citation and Notification of Penalty. You may contest
all citation items or only individual items. You may also contest proposed penalties and/or abatement dates
without contesting the underlying violations. Unless you inform the Area Director in writing that you intend
to contest the citation(s) and/or proposed penalty(ies) within 15 working days after receipt, the citation(s)
and the proposed penalty(ies) will become a final order of the Occupational Safety and Health Review
Commission and may not be reviewed by any court or agency.
Penalty Payment – Penalties are due within 15 working days of receipt of this notification unless contested.
(See the enclosed booklet and the additional information provided related to the Debt Collection Act of 1982.)
Make your check or money order payable to “DOL-OSHA”. Please indicate the Inspection Number on the
remittance. You can also make your payment electronically at www.pay.gov. At the top of the pay.gov homepage,
type "OSHA" in the Search field and select Search. From OSHA Penalty Payment Form search result, select
Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
You will be required to enter your inspection number when making the payment. Payments can be made by
credit card or Automated Clearing House (ACH) using your banking information. Payments of $25,000 or more
require a Transaction ID, and also must be paid using ACH. If you require a Transaction ID, please contact the
OSHA Debt Collection Team at (202) 693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or
electronic payment for less than the full amount due, and will process the payments as if these restrictions or
conditions do not exist.
Notification of Corrective Action – For each violation which you do not contest, you must provide
abatement certification to the Area Director of the OSHA office issuing the citation and identified above. This
abatement certification is to be provided by letter within 10 calendar days after each abatement date. Abatement
certification includes the date and method of abatement. If the citation indicates that the violation was corrected
during the inspection, no abatement certification is required for that item. The abatement certification letter must
be posted at the location where the violation appeared and the corrective action took place or employees must
otherwise be effectively informed about abatement activities. A sample abatement certification letter is enclosed
with this Citation. In addition, where the citation indicates that abatement documentation is necessary, evidence
of the purchase or repair of equipment, photographs or video, receipts, training records, etc., verifying that
abatement has occurred is required to be provided to the Area Director.
Employer Discrimination Unlawful – The law prohibits discrimination by an employer against an
Citation and Notification of Penalty Page 3 OSHA-2
employee for filing a complaint or for exercising any rights under this Act. An employee who believes that
he/she has been discriminated against may file a complaint no later than 30 days after the discrimination
occurred with the U.S. Department of Labor Area Office at the address shown above.
Employer Rights and Responsibilities – The enclosed booklet (OSHA 3000) outlines additional
employer rights and responsibilities and should be read in conjunction with this notification.
Notice to Employees – The law gives an employee or his/her representative the opportunity to object to any
abatement date set for a violation if he/she believes the date to be unreasonable. The contest must be mailed to
the U.S. Department of Labor Area Office at the address shown above and postmarked within 15 working days
(excluding weekends and Federal holidays) of the receipt by the employer of this Citation and Notification of
Penalty.
Inspection Activity Data – You should be aware that OSHA publishes information on its inspection and
citation activity on the Internet under the provisions of the Electronic Freedom of Information Act. The
information related to these alleged violations will be posted when our system indicates that you have received
this citation. You are encouraged to review the information concerning your establishment at www.osha.gov. If
you have any dispute with the accuracy of the information displayed, please contact this office.
Citation and Notification of Penalty Page 4 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
NOTICE TO EMPLOYEES OF INFORMAL CONFERENCE
An informal conference has been scheduled with OSHA to discuss the citation(s) issued on
12/15/2022. The conference will be held by telephone or
at the OSHA office located at 1851
Executive Center Drive, Suite 227, Jacksonville, FL 32207 on _________________ at
_________________. Employees and/or representatives of employees have a right to attend an
informal conference.
Citation and Notification of Penalty Page 5 OSHA-2
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET
Inspection Number: 1608788
Company Name: Amazon.com Services LLC-MCO2
Inspection Site: 2600 N Normandy Blvd., Deltona, FL 32725
Issuance Date: 12/15/2022
List the specific method of correction for each item on this citation in this package that does not read “Corrected
During Inspection” and return to: U.S. Department of Labor – Occupational Safety and Health
Administration, 1851 Executive Center Drive, Suite 227, Jacksonville, FL 32207.
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
I certify that the information contained in this document is accurate and that the affected employees and their
representatives have been informed of the abatement.
________________________________ ________________________________
Signature Date
________________________________ ________________________________
Typed or Printed Name Title
NOTE: 29 USC 666(g) whoever knowingly makes any false statements, representation or certification in any application, record, plan or
other documents filed or required to be maintained pursuant to the Act shall, upon conviction, be punished by a fine of not more than
$10,000 or by imprisonment of not more than 6 months or both.
POSTING: A copy of completed Corrective Action Worksheet should be posted for employee review
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1608788
Inspection Date(s): 07/18/2022 - 07/22/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC-MCO2
Inspection Site: 2600 N Normandy Blvd., Deltona, FL 32725
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 6 OSHA-2
Citation 1 Item 1 Type of Violation: Other-than-Serious
29 CFR 1904.7(b)(4): The employer did not correctly classify the following work-related injuries or illnesses on the
OSHA Form 300 or equivalent.
At 2600 N Normandy Blvd, Deltona, FL 32725: On or about 7/18/2022, the employer failed to enter the correct
number of days of work restriction for the following work-related injury on the OSHA Form 300 or equivalent for
the calendar year 2022:
(a) On or about 7/3/2022, an employee was lifting boxes and strained their left wrist. The injury was recorded on
OSHA's Form 300 with 53 job transfer or restricted workdays even though there were at least 84 workdays of work
restriction.
Abatement Certification and Documentation is required
Date By Which Violation Must be Abated: December 30, 2022
Proposed Penalty: $2,072.00
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1608788
Inspection Date(s): 07/18/2022 - 07/22/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC-MCO2
Inspection Site: 2600 N Normandy Blvd., Deltona, FL 32725
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 7 OSHA-2
Citation 1 Item 2 Type of Violation: Other-than-Serious
29 CFR 1904.40(a):The employer did not provide an authorized government representative the records within the
four business hours.
(a) At 2600 N Normandy Blvd, Deltona, FL 32725: On or about 7/18/2022, the employer did not provide to OSHA,
the OSHA Forms 300, 300a, and 301 within the four business hours of when they were requested.
ABATEMENT DOCUMENTATION REQUIRED FOR THIS ITEM
Date By Which Violation Must be Abated: Quick Fix
Proposed Penalty: $2,072.00
______________________________
David Tisdale
Area Director
______________________________________________________________________________________________________________________
DAVID TISDALE
Digitally signed by DAVID TISDALE
Date: 2022.12.15 15:21:21 -05'00'
Citation and Notification of Penalty Page 8 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
1851 Executive Center Drive
Suite 227
Jacksonville, FL 32207
INVOICE /
DEBT COLLECTION NOTICE
Company Name: Amazon.com Services LLC-MCO2
Inspection Site: 2600 N Normandy Blvd., Deltona, FL 32725
Issuance Date: 12/15/2022
Summary of Penalties for Inspection Number: 1608788
Citation 1 Item 1, Other-than-Serious
$2,072.00
Citation 1 Item 2, Other-than-Serious
$2,072.00
TOTAL PROPOSED PENALTIES:
$4,144.00
To avoid additional charges, please remit payment promptly to this Area Office for the total amount of the
uncontested penalties summarized above. Make your check or money order payable to: "DOL-OSHA". Please
indicate OSHA's Inspection Number (indicated above) on the remittance. You can also make your payment
electronically at www.pay.gov. At the top of the pay.gov homepage, type “OSHA” in the Search field and select
Search. From the OSHA Penalty Payment Form search result, select Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334. You will be required to enter
your inspection number when making the payment. Payments can be made by credit card or Automated Clearing
House (ACH) using your banking information. Payments of $25,000 or more require a Transaction ID, and also
must be paid using ACH. If you require a Transaction ID, please contact the OSHA Debt Collection Team at (202)
693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or electronic
payment for less than the full amount due, and will cash the check or money order as if these restrictions or
conditions do not exist.
If a personal check is issued, it will be converted into an electronic fund transfer (EFT). This means that our bank
will copy your check and use the account information on it to electronically debit your account for the amount of
the check. The debit from your account will then usually occur within 24 hours and will be shown on your regular
account statement. You will not receive your original check back. The bank will destroy your original check, but
will keep a copy of it. If the EFT cannot be completed because of insufficient funds or closed account, the bank will
attempt to make the transfer up to two times.
Pursuant to the Debt Collection Act of 1982 (Public Law 97-365) and regulations of the U.S. Department of Labor
(29 CFR Part 20), the Occupational Safety and Health Administration is required to assess interest, delinquent
Citation and Notification of Penalty Page 9 OSHA-2
charges, and administrative costs for the collection of delinquent penalty debts for violations of the Occupational
Safety and Health Act.
Interest: Interest charges will be assessed at an annual rate determined by the Secretary of the Treasury on all
penalty debt amounts not paid within one month (30 calendar days) of the date on which the debt amount becomes
due and payable (penalty due date). The current interest rate is one percent (1%). Interest will accrue from the date
on which the penalty amounts (as proposed or adjusted) become a final order of the Occupational Safety and Health
Review Commission (that is, 15 working days from your receipt of the Citation and Notification of Penalty), unless
you file a notice of contest. Interest charges will be waived if the full amount owed is paid within 30 calendar days
of the final order.
Delinquent Charges: A debt is considered delinquent if it has not been paid within one month (30 calendar days) of
the penalty due date or if a satisfactory payment arrangement has not been made. If the debt remains delinquent for
more than 90 calendar days, a delinquent charge of six percent (6%) per annum will be assessed accruing from the
date that the debt became delinquent.
Administrative Costs: Agencies of the Department of Labor are required to assess additional charges for the
recovery of delinquent debts. These additional charges are administrative costs incurred by the Agency in its
attempt to collect an unpaid debt. Administrative costs will be assessed for demand letters sent in an attempt to
collect the unpaid debt.
_________________________________________
___________________________
David Tisdale
Date
Area Director
DAVID TISDALE
Digitally signed by DAVID
TISDALE
Date: 2022.12.15 15:21:53 -05'00'
U.S. Department of Labor
12/15/2022
Amazon.com Services LLC - MDW8
and its successors
1750 Bridge Dr,
Waukegan, IL 60085
Dear Employer:
Enclosed you will find citations for violations of the Occupational Safety and Health Act of 1970 (the Act) which
may have accompanying proposed penalties. Also enclosed is a booklet entitled, “Employer Rights and
Responsibilities Following an OSHA Inspection”, (OSHA 3000-04R) revised 2018, which explains your rights
and responsibilities under the Act. If you have any questions about the enclosed citations and penalties, I would
welcome further discussions in person or by telephone. Please contact me at (847) 227-1700.
You will note on page 6 of the booklet that, for violations which you do not contest, you must (1) notify this
office promptly by letter that you have taken appropriate corrective action within the time set forth on the
citation; and (2) pay any penalties assessed. Please inform me of the abatement steps you have taken and of their
dates together with adequate supporting documentation; e.g., drawings or photographs of corrected conditions,
purchase/work orders related to abatement actions, air sampling results. This information will allow us to close
the case.
As indicated on page 3 of the booklet, you may request an informal conference with me during the 15-working-
day notice of contest period. During such an informal conference you may present any evidence or views which
you believe would support an adjustment to the citation or the penalty.
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of the citation. The running of this contest
period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete the attached notice at the bottom of this letter
and post it next to the Citations as soon as the time, date and the place of the informal conference have been
determined. Be sure to bring to the conference with you any and all supporting documentation of existing
conditions as well as of any abatement steps taken thus far. If conditions warrant, we can enter into an informal
settlement agreement which amicably resolves this matter without litigation or contest.
Occupational Safety and Health Administration
2020 S. Arlington Heights Road
Suite 102
Arlington Heights, IL 60005
You should be aware that OSHA publishes information on its inspection and citation activity on the Internet
under the provisions of Electronic Freedom of Information Act. The information related to these alleged
violations will be posted when our system indicates that you have received this citation. You are encouraged to
review the information concerning your establishment at www.osha.gov. If you have any dispute with the
accuracy of the information displayed, please contact this office.
Sincerely,
Angeline Loftus
Area Director
Enclosures
ANGELINE
LOFTUS
Digitally signed by ANGELINE
LOFTUS
Date: 2022.12.15 14:55:37
-06'00'
Citation and Notification of Penalty Page 1 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
2020 S. Arlington Heights Road
Suite 102
Arlington Heights, IL 60005
Citation and Notification of Penalty
To:
Amazon.com Services LLC - MDW8
and its successors
1750 Bridge Dr,
Waukegan, IL 60085
Inspection Number: 1608898
Inspection Date(s): 07/18/2022 - 12/15/2022
Issuance Date: 12/15/2022
Inspection Site:
1750 Bridge Dr,
Waukegan, IL 60085
The violation(s) described in this Citation and
Notification of Penalty is (are) alleged to have
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 (this Citation) describes violations of the Occupational Safety and
Health Act of 1970. The penalty(ies) listed herein is (are) based on these violations. You must abate the
violations referred to in this Citation by the dates listed and pay the penalties proposed, unless within 15 working
days (excluding weekends and Federal holidays) from your receipt of this Citation and Notification of Penalty
you either call to schedule an informal conference (see paragraph below) or you mail a notice of contest to
the U.S. Department of Labor Area Office at the address shown above. Please refer to the enclosed booklet
(OSHA 3000) which outlines your rights and responsibilities and which should be read in conjunction with this
form. Issuance of this Citation does not constitute a finding that a violation of the Act has occurred unless there
is a failure to contest as provided for in the Act or, if contested, unless this Citation is affirmed by the Review
Commission or a court.
Posting - The law requires that a copy of this Citation and Notification of Penalty be posted immediately in a
prominent place at or near the location of the violation(s) cited herein, or, if it is not practicable because of the
nature of the employer's operations, where it will be readily observable by all affected employees. This Citation
must remain posted until the violation(s) cited herein has (have) been abated, or for 3 working days (excluding
weekends and Federal holidays), whichever is longer.
Informal Conference - An informal conference is not required. However, if you wish to have such a
conference you may request one with the Area Director during the 15 working day contest period by calling
(847) 227-1700. During such an informal conference, you may present any evidence or views which you believe
would support an adjustment to the citation(s) and/or penalty(ies).
Citation and Notification of Penalty Page 2 OSHA-2
If you are considering a request for an informal conference to discuss any issues related to this Citation and
Notification of Penalty, you must take care to schedule it early enough to allow time to contest after the informal
conference, should you decide to do so. Please keep in mind that a written letter of intent to contest must be
submitted to the Area Director within 15 working days of your receipt of this Citation. The running of this
contest period is not interrupted by an informal conference.
If you decide to request an informal conference, please complete, remove and post the Notice to Employees next
to this Citation and Notification of Penalty as soon as the time, date, and place of the informal conference have
been determined. 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 informal settlement
agreement which amicably resolves this matter without litigation or contest.
Right to Contest – You have the right to contest this Citation and Notification of Penalty. You may contest
all citation items or only individual items. You may also contest proposed penalties and/or abatement dates
without contesting the underlying violations. Unless you inform the Area Director in writing that you intend
to contest the citation(s) and/or proposed penalty(ies) within 15 working days after receipt, the citation(s)
and the proposed penalty(ies) will become a final order of the Occupational Safety and Health Review
Commission and may not be reviewed by any court or agency.
Penalty Payment – Penalties are due within 15 working days of receipt of this notification unless contested.
(See the enclosed booklet and the additional information provided related to the Debt Collection Act of 1982.)
Make your check or money order payable to “DOL-OSHA”. Please indicate the Inspection Number on the
remittance. You can also make your payment electronically at www.pay.gov. At the top of the pay.gov homepage,
type "OSHA" in the Search field and select Search. From OSHA Penalty Payment Form search result, select
Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
You will be required to enter your inspection number when making the payment. Payments can be made by
credit card or Automated Clearing House (ACH) using your banking information. Payments of $25,000 or more
require a Transaction ID, and also must be paid using ACH. If you require a Transaction ID, please contact the
OSHA Debt Collection Team at (202) 693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or
electronic payment for less than the full amount due, and will process the payments as if these restrictions or
conditions do not exist.
Notification of Corrective Action – For each violation which you do not contest, you must provide
abatement certification to the Area Director of the OSHA office issuing the citation and identified above. This
abatement certification is to be provided by letter within 10 calendar days after each abatement date. Abatement
certification includes the date and method of abatement. If the citation indicates that the violation was corrected
during the inspection, no abatement certification is required for that item. The abatement certification letter must
be posted at the location where the violation appeared and the corrective action took place or employees must
otherwise be effectively informed about abatement activities. A sample abatement certification letter is enclosed
with this Citation. In addition, where the citation indicates that abatement documentation is necessary, evidence
of the purchase or repair of equipment, photographs or video, receipts, training records, etc., verifying that
abatement has occurred is required to be provided to the Area Director.
Employer Discrimination Unlawful – The law prohibits discrimination by an employer against an
Citation and Notification of Penalty Page 3 OSHA-2
employee for filing a complaint or for exercising any rights under this Act. An employee who believes that
he/she has been discriminated against may file a complaint no later than 30 days after the discrimination
occurred with the U.S. Department of Labor Area Office at the address shown above.
Employer Rights and Responsibilities – The enclosed booklet (OSHA 3000) outlines additional
employer rights and responsibilities and should be read in conjunction with this notification.
Notice to Employees – The law gives an employee or his/her representative the opportunity to object to any
abatement date set for a violation if he/she believes the date to be unreasonable. The contest must be mailed to
the U.S. Department of Labor Area Office at the address shown above and postmarked within 15 working days
(excluding weekends and Federal holidays) of the receipt by the employer of this Citation and Notification of
Penalty.
Inspection Activity Data – You should be aware that OSHA publishes information on its inspection and
citation activity on the Internet under the provisions of the Electronic Freedom of Information Act. The
information related to these alleged violations will be posted when our system indicates that you have received
this citation. You are encouraged to review the information concerning your establishment at www.osha.gov. If
you have any dispute with the accuracy of the information displayed, please contact this office.
Citation and Notification of Penalty Page 4 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
NOTICE TO EMPLOYEES OF INFORMAL CONFERENCE
An informal conference has been scheduled with OSHA to discuss the citation(s) issued on
12/15/2022. The conference will be held by telephone or
at the OSHA office located at 2020 S.
Arlington Heights Road, Suite 102, Arlington Heights, IL 60005 on _________________ at
_________________. Employees and/or representatives of employees have a right to attend an
informal conference.
Citation and Notification of Penalty Page 5 OSHA-2
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET
Inspection Number: 1608898
Company Name: Amazon.com Services LLC - MDW8
Inspection Site: 1750 Bridge Dr,, Waukegan, IL 60085
Issuance Date: 12/15/2022
List the specific method of correction for each item on this citation in this package that does not read “Corrected
During Inspection” and return to: U.S. Department of Labor – Occupational Safety and Health
Administration, 2020 S. Arlington Heights Road, Suite 102, Arlington Heights, IL 60005.
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
Citation Number _____ and Item Number _____ was corrected on __________________________________
By (Method of Abatement): _________________________________________________________________
________________________________________________________________________________________
I certify that the information contained in this document is accurate and that the affected employees and their
representatives have been informed of the abatement.
________________________________ ________________________________
Signature Date
________________________________ ________________________________
Typed or Printed Name Title
NOTE: 29 USC 666(g) whoever knowingly makes any false statements, representation or certification in any application, record, plan or
other documents filed or required to be maintained pursuant to the Act shall, upon conviction, be punished by a fine of not more than
$10,000 or by imprisonment of not more than 6 months or both.
POSTING: A copy of completed Corrective Action Worksheet should be posted for employee review
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1608898
Inspection Date(s): 07/18/2022 - 12/15/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC - MDW8
Inspection Site: 1750 Bridge Dr,, Waukegan, IL 60085
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 6 OSHA-2
Citation 1 Item 1 Type of Violation: Other-than-Serious
29 CFR 1904.7(b)(3): The employer did not correctly classify the following work-related injuries or illnesses
involving days away from work and/or failed to enter the number of calendar days away from work on the OSHA
Form 300 or equivalent:
Amazon.com Services LLC - MDW8 in Waukegan, IL - On or about July 18, 2022, and November 18, 2022, the
employer had not correctly entered the following workplace injury on the OSHA Form 300 or its equivalent for the
calendar year 2022. Violative instances included but were not limited to:
(a) Case No. 10 (Outbound Ship Dock Load - upper back injury while manually moving a gas grill) occurring on
6/22/2022 was not filled out under Column H to classify the case as involving days away from work and Column K
to include the number of days away from work. The case was classified as an other recordable case without any
days away from work even though the injury resulted in days away from work.
In accordance with 29 CFR 1903.19(c), abatement certification is required for this violation (using the
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET).
Date By Which Violation Must be Abated: January 12, 2023
Proposed Penalty: $2,072.00
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1608898
Inspection Date(s): 07/18/2022 - 12/15/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC - MDW8
Inspection Site: 1750 Bridge Dr,, Waukegan, IL 60085
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 7 OSHA-2
Citation 1 Item 2 Type of Violation: Other-than-Serious
29 CFR 1904.7(b)(4): The employer did not correctly classify the following work-related injuries or illnesses
involving restricted work or job transfer and/or failed to enter the number of calendar days of job transfer or
restriction on the OSHA Form 300 or equivalent:
Amazon.com Services LLC - MDW8 in Waukegan, IL - On or about November 18, 2022, and July 18, 2022, the
employer had not correctly entered the following workplace injuries on the OSHA Form 300 or its equivalent for
the calendar year 2022. Violative instances included but were not limited to:
(a) Case No. 10 (Outbound Ship Dock Load - upper back injury while manually moving a gas grill) occurring on
6/22/2022 was not filled out under Column L to include the number of days on job transfer or restriction. The case
was classified at an other recordable case without any days of job transfer or restriction even though the injury
resulted in days of job transfer/restriction.
(b) Case No. 8 (Outbound Ship Dock Sort - lower leg injury while manually moving fitness equipment) occurring
on 6/23/2022 was not filled out under Column L to include the number of days on job transfer or restriction. The
case was initially recorded as a days away from work case without any days of job transfer or restriction even
though the injury resulted in days of job transfer/restriction.
In accordance with 29 CFR 1903.19(c), abatement certification is required for this violation (using the
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET).
Date By Which Violation Must be Abated: January 12, 2023
Proposed Penalty: $2,072.00
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1608898
Inspection Date(s): 07/18/2022 - 12/15/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC - MDW8
Inspection Site: 1750 Bridge Dr,, Waukegan, IL 60085
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 8 OSHA-2
Citation 1 Item 3 Type of Violation: Other-than-Serious
29 CFR 1904.29(b)(1): The employer did not provide the required injury or illness descriptions on the OSHA Form
300 or equivalent:
Amazon.com Services LLC - MDW8 in Waukegan, IL - On or about July 18, 2022, the employer had not provided
the required description of the injury or illness, parts of body affected, and object/substance that directly injured or
made person ill on the OSHA Form 300 or its equivalent for the calendar year 2022. Violative instances included
but were not limited to:
(a) Case No. 9 (Outbound Ship Dock Pick - head injury) occurring on 6/20/2022 did not contain a complete entry in
Column F, description for the recordable injury. Column F only contained the word 'Strain'. Missing was the part(s)
of the body affected, head, and the object/substance that directly injured the employee, PIT harness hook fixture. In
addition, the primary injury was not a strain of a muscle but rather a head injury. The secondary injury was a
cervical strain.
(b) Case No. 10 (Outbound Ship Dock Load - upper back injury) occurring on 6/22/2022 did not contain a complete
entry in Column F, description for the recordable injury. Column F only contained the work 'Strain'. Missing was
the part(s) of the body affected, upper back, and the object and the object/substance that directly injured the
employee, a 90 lb. propane gas grill.
(c) Case No. 8 (Outbound Ship Dock Sort - lower leg injury) occurring on 6/23/2022 did not contain a complete
entry in Column F, description for the recordable injury. Column F only contained the word 'Left lower Sin [sic]'.
Missing was the nature of the injury, contusion, and the object/substance that directly injured the employee, a 148
lb. fitness equipment package.
In accordance with 29 CFR 1903.19(c), abatement certification is required for this violation (using the
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET).
Date By Which Violation Must be Abated: January 12, 2023
Proposed Penalty: $2,072.00
U.S. Department of Labor
Occupational Safety and Health Administration
Inspection Number: 1608898
Inspection Date(s): 07/18/2022 - 12/15/2022
Issuance Date: 12/15/2022
Citation and Notification of Penalty
Company Name: Amazon.com Services LLC - MDW8
Inspection Site: 1750 Bridge Dr,, Waukegan, IL 60085
See pages 1 through 4 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities.
Citation and Notification of Penalty Page 9 OSHA-2
Citation 1 Item 4 Type of Violation: Other-than-Serious
29 CFR 1904.29(b)(2): The employer did not fill out or correctly fill out an OSHA Form 301 or equivalent for each
recordable injury or illness:
Amazon.com Services LLC - MDW8 in Waukegan, IL - On or about July 18, 2022, the employer had not filled out
OSHA Forms 301 in completeness for the calendar year 2022. Violative instances included but were not limited to:
(a) Case No. 10 (Outbound Ship Dock Load - upper back injury) occurring on 6/22/2022 had an OSHA Form 301
that was not filled out in a complete manner. Question 15 was filled out 'Strain' and failed to describe how the injury
occurred, employee tried to TPS a 90 lb. propane gas grill package while loading a trailer. Question 16 was filled
out 'Strain' and failed to describe what the injury was in terms of part of the body affected, upper back. Question 17
was filled out 'Other equipment; Other' and failed to describe what object directly harmed the employee, a 90 lb.
propane gas grill package.
(b) Case No. 8 (Outbound Ship Dock Sort - lower leg injury) occurring on 6/23/2022 had an OSHA Form 301 that
was not filled out in a complete manner. Question 16 was filled out 'Left lower sin [sic]' and failed to describe what
the injury was in terms of how that part of the body was affected, contusion. Question 17 was not filled out and
failed to describe what object directly harmed the employee, a 148 lb. fitness equipment package.
In accordance with 29 CFR 1903.19(c), abatement certification is required for this violation (using the
CERTIFICATION OF CORRECTIVE ACTION WORKSHEET).
Date By Which Violation Must be Abated: January 12, 2023
Proposed Penalty: $2,072.00
______________________________
Angeline Loftus
Area Director
______________________________________________________________________________________________________________________
ANGELINE LOFTUS
Digitally signed by ANGELINE
LOFTUS
Date: 2022.12.15 14:55:05 -06'00'
Citation and Notification of Penalty Page 10 OSHA-2
U.S. Department of Labor
Occupational Safety and Health Administration
2020 S. Arlington Heights Road
Suite 102
Arlington Heights, IL 60005
INVOICE /
DEBT COLLECTION NOTICE
Company Name: Amazon.com Services LLC - MDW8
Inspection Site: 1750 Bridge Dr,, Waukegan, IL 60085
Issuance Date: 12/15/2022
Summary of Penalties for Inspection Number: 1608898
Citation 1 Item 1, Other-than-Serious
$2,072.00
Citation 1 Item 2, Other-than-Serious
$2,072.00
Citation 1 Item 3, Other-than-Serious
$2,072.00
Citation 1 Item 4, Other-than-Serious
$2,072.00
TOTAL PROPOSED PENALTIES:
$8,288.00
To avoid additional charges, please remit payment promptly to this Area Office for the total amount of the
uncontested penalties summarized above. Make your check or money order payable to: "DOL-OSHA". Please
indicate OSHA's Inspection Number (indicated above) on the remittance. You can also make your payment
electronically at www.pay.gov. At the top of the pay.gov homepage, type “OSHA” in the Search field and select
Search. From the OSHA Penalty Payment Form search result, select Continue. The direct link is:
https://www.pay.gov/paygov/forms/formInstance.html?agencyFormId=53090334
. You will be required to enter
your inspection number when making the payment. Payments can be made by credit card or Automated Clearing
House (ACH) using your banking information. Payments of $25,000 or more require a Transaction ID, and also
must be paid using ACH. If you require a Transaction ID, please contact the OSHA Debt Collection Team at (202)
693-2170.
OSHA does not agree to any restrictions or conditions or endorsements put on any check, money order, or electronic
payment for less than the full amount due, and will cash the check or money order as if these restrictions or
conditions do not exist.
If a personal check is issued, it will be converted into an electronic fund transfer (EFT). This means that our bank
will copy your check and use the account information on it to electronically debit your account for the amount of
the check. The debit from your account will then usually occur within 24 hours and will be shown on your regular
account statement. You will not receive your original check back. The bank will destroy your original check, but
will keep a copy of it. If the EFT cannot be completed because of insufficient funds or closed account, the bank will
attempt to make the transfer up to two times.
Citation and Notification of Penalty Page 11 OSHA-2
Pursuant to the Debt Collection Act of 1982 (Public Law 97-365) and regulations of the U.S. Department of Labor
(29 CFR Part 20), the Occupational Safety and Health Administration is required to assess interest, delinquent
charges, and administrative costs for the collection of delinquent penalty debts for violations of the Occupational
Safety and Health Act.
Interest: Interest charges will be assessed at an annual rate determined by the Secretary of the Treasury on all
penalty debt amounts not paid within one month (30 calendar days) of the date on which the debt amount becomes
due and payable (penalty due date). The current interest rate is one percent (1%). Interest will accrue from the date
on which the penalty amounts (as proposed or adjusted) become a final order of the Occupational Safety and Health
Review Commission (that is, 15 working days from your receipt of the Citation and Notification of Penalty), unless
you file a notice of contest. Interest charges will be waived if the full amount owed is paid within 30 calendar days
of the final order.
Delinquent Charges: A debt is considered delinquent if it has not been paid within one month (30 calendar days) of
the penalty due date or if a satisfactory payment arrangement has not been made. If the debt remains delinquent for
more than 90 calendar days, a delinquent charge of six percent (6%) per annum will be assessed accruing from the
date that the debt became delinquent.
Administrative Costs: Agencies of the Department of Labor are required to assess additional charges for the
recovery of delinquent debts. These additional charges are administrative costs incurred by the Agency in its
attempt to collect an unpaid debt. Administrative costs will be assessed for demand letters sent in an attempt to
collect the unpaid debt.
_________________________________________
___________________________
Angeline Loftus
Date
Area Director
ANGELINE LOFTUS
Digitally signed by ANGELINE
LOFTUS
Date: 2022.12.15 14:54:35 -06'00'
