North Carolina Department of Labor Occupational Safety and Health Division 1101 Mail Service Center Raleigh, NC 27699 Phone: 919-779-8570 FAX: 919-420-7966 ‘Ted Hendrix/NB Citation and Notification of Penalty To: Inspection Number; 318265741 Cape Fear Habitat for Humanity, Inc. CSHO ID: LN73 3310 Fredrickson Road Activity ID No,: 154255 Wilmington, NC 28401 Inspection Date(s): 5/16/2023 Issuance Date: 8/14/2023 Inspection Site: 7330 Market Street The violation(s) described in this Citation and ‘Wilmington, NC 28411 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 describes violation(s) of the Inbor laws of Chapter 95 of the North Carolina General Statutes. The penalty(ies) listed herein is (are) based on these violations, You must correct the violations) referred to in this citation by the date(s) listed and pay the penalty proposed, unless within 15 working days (excluding weekends and holidays) from receipt of this Citation and Notification of Penalty, you mail a request for an informal conference or Notice of Contestinent to the North Carolina Department of Labor district office at the address shown above. 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 State holidays), whichever is longer, The penalty dollar amounts need not be posted and may be marked out or covered up prior to posting, Informal Conference - You may request an informal conference, To request an informal conférence, ‘you must return the enclosed form marking the block requesting an informal conference or provide other written notice to the district supervisor within 15 working days of receipt of the citation, Do not mark more than one block on the enclosed form If you want an informal conference. The informal conference must be held no longer than 20 working days from the date you receive the Citation and Notification of Penalty, so your immediate response is necessary if you choose this option, Ifyou make a timely request for an informal conference to discuss any issues related to this Citation and Notification of Penalty, you preserve your right (0 contest, The time for contestment does not begin until Citation and Notification of Penalty Page 1 of 12 (OSHA? (Rev 1/14)after the informal conference is held and you have been notified of the result(s), At that time you have an additional 15 working days during which you may file a notice of contest, should you so desire, If you decide to request an informal conférence, obtain the date, time and location of the informal conference by contacting the District Supervisor, then complete and post the enclosed Notice to Employees near the Citation and Notification of Penalty. Please bring to the conference all supporting documentation of existing conditions and any corrections made thus far. The results of the informal conference will be a revised citation, a notice of no change ot an informal settlement agreement, An informal settlement agreement will resolve the matter without litigation or contestment. Right to Contest - You have the right to contest this Citation and Notification of Penalty now or after an informal conference. 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. 15 working days after you reeeive this Citation and Notification of Penalty (If you do not request an informal conference) or 15 working days after you receive the results of the informal conference, the citation(s) and/or proposed penalty(les) will become a final order of the North Carolina Occupational Safety and Health Review Commission and may not be reviewed by any court or agency, unless you file a notice of contestment, Penalty Payment - Penalties are due within 15 working days of receipt of this notification unless a request for an informal conference or notice of contestment is forwarded. Make your check or money order payable to the North Carolina Department of Labor, OSHA Division and remit to the Financial Services Division at 1101 Mail Service Center, Raleigh, NC 27699-1101. Pay online at www.labor.ne.gov. We accept VISA, MasterCard, and B-Cheeks, You may also fax your payments to (919) 715-9094, or mail it to: N.C. Department of Labor, Financial Services Division, 1101 Mail Service Center, Raleigh NC 27699-1101. You may also make payment by credit card, A form is provided for your convenience, Please indicate the inspection number on the remittance, Pursuant (0 N.C, Gen, Stat, Section 147-86.23 interest shall be charged at the rate of five percent (5%) per year on a past-due account receivable from the date the account receivable was due until itis paid, In addition, a late payment penalty of ten percent (10%) of the account receivable shall be added to past-due account receivable. A late-paymnent penalty may be waived for good cause shown, ‘The North Carolina Department of Labor does not agree to any restriction ot conditions or endorsements you put on any check or money order for less than the full amount due, and wall cash the check or money order as if these restrictions, conditions, or endorsements do not exist. Notification of Corrective Action - For violations which you do not contest, you should return the OSHA Form 2D (Certification of Abatement) within ten (10) calendar days after the abatement date, to indicate that appropriate corrective action has been taken within the time frame set forth in this citation, You are not required to certify abatement if the inspector observed the abatement during the on-site portion of the inspection or observes within 24 hours after identifying the hazard and notes in the citation that abatement has occurred. The certification that abatement is complete must include, for each cited violation, the date bnd method of abatement and a statement that affected employees and their representatives have been informed of the abatement, Giation end Notification of Penalty Page 2 of 12 ‘OSHA2 Rev 14)1 In addition, for repeat, willful and other serious violations as indicated, additional documents demonstrating that abatement is complete is required. This additional documentation may include, but is not limited to, evidence of the purchase or repair of equipment, photographic or video evidence of abatement or other written records. If indicated in the citation, you may be required to submit an abatement plan for each cited violation, when time permitted for abatement is more than 90 calendar days, The plan must identify the violation and the steps to be taken to achieve abatement, including a schedule for completing abatement and how employees will be protected from exposure lo the violative condition in the interim until abatement is complete. An employer who submits an abatement plan may be required to also submit periodic progress reports for each cited violation, The citation will indicate whether progress plans are due and the date(s) when the progress reports are due, The employer must include, in each submission required by this notification, company name and address, inspection number, citation and item numbers, @ statement that the information submitted is accurate, and a signature of the employer or the employer's authorized representative, The date of the postmark is the date of submission for mailed documents. Employee Notification of Corrective Action - The employer must inform affected employees and their reptesentative(s) about abatement activities, covered by the citations, by posting a copy of each document submitted to the North Carolina Department of Labor, or a summary of the document near the place where the violation occurred, or where it will be readily observable, The employer must inform employees of their right to examine and copy all abatement documents submitted. Posted documents must remain posted for three working days after submission to the Department. Employer Discrimination Untawful - 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 e complaint no later then 180 days after the discrimination occurred with the NC Department of Labor at the address shown above. 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 in writing and signed. It must be mailed to the North Carolina Department of Labor at the address shown above and postmarked within 20 days of the receipt by the employer of this Citation and Notification of Penalty, Notice to Employer - Enclosed are citations and proposed penalties levied against your facility resulting fiom the Division of Occupational Safety and Health's compliance inspection of your facility. The penalty for each violation has been reduced depending on your facility's size, good faith and history. Notice to Employer - To view your establishment(s) inspection on the Federal OSHA web site please use the Activity ID number on Page one (1), Citation and Notification of Penalty Poge3 of 12 OSHA? (Rev 1714)CREDIT CARD PAYMENT Complete and return to: ‘North Carolina Department of Labor Financial Services Division 1101 Mail Service Center Raleigh, NC 27699-1101 ‘Telephone: (919) 707-7742 Fax: (919) 715-9094 Name: Addres Phone #: Amount: ‘Name (as it appears on ere card): Credit Card Number: gs (Guoleone) Mastercard Visa Exp. Date: Mor Cardholder Signature: Payment for Invoice Nos. Dat Pay online at www.labor.ne.gov, We accept VISA, MasterCard, and E-Checks. You may also fax your payments to (919) 715-9094, or mail it to: N.C, Department of Labor, Financial Services Division, 1101 Mail Service Center, Raleigh, NC 27699-1101, ‘Giition end Notification of Penaliy Page 4 of 12 OSHAD Rev 1714)North Carolina Department of Labor | | Occupational Safety and Health Division BU ‘THIS FORM IS FOR YOUR CONVENIENCE IN REQUESTING AN INFORMAL CONFERENCE OR FOR CONTESTING PART OR ALL OF THE ENCLOSED CITATION(S). THE FORM OR YOUR REQUEST FOR AN INFORMAL CONFERENCE OR NOTICE TO CONTEST MUST BE POSTMARKED WITHIN 15 WORKING DAYS OF RECEIPT OF THE CITATION(S). Cape Fear Habitat for Humanity, Inc, 3310 Fredrickson Road Wilmington, NC 28401 Inspection Number 318265741 Please mark only one of the following boxes and return to the address indicated below. Forms returned with more than one box marked will be treated as a request for an informal conference. PENALTY PAYMENT ENCLOSED IN THE AMOUNT OF $. Remitio; NC Department of Labor ATTN: Finsncial Services Division 1101 Mail Service Center Raleigh, NC 27699-1101, Pay online at www.labor.ne.gov. We accept MasterCard, VISA, E-Checks. You may also fax your payment to (919) 715-9094, or mail it to: N.C. Department of Labor, Financial Services Division, 1101 Mail Service Center, Raleigh, NC 27699-1101. REQUEST AN INFORMAL CONFERENCE (YOUR RIGHT TO CONTEST IS RESERVED PENDING ‘THE RESULTS OF THE INFORMAL CONFERENCE) NOTICE OF CONTEST OF CITATION(S) AND/OR PROPOSED PENALTY Contest of Violations) Date(s)/Abaterment Dates(s) Contestment of Penalty Amount(s) Reumior NC Department of Later n of Occupational Safety and Heelth sates Note Brown 1101 Mail Service Center Raleigh, NC 27699 Tel: 919-779-8570 Fax: 919-420-7966 Signature: Name (Print): Title: Email Address: ‘Telephone No.: (__). Fax No. ( Date: ‘Gitation and Notification of Penalty Page 5 of 12 ‘OSHA Rev 14)North Carolina Department of Labor Oceupational Safety and Health Division NOTICE TO EMPLOYEES OF INFORMAL CONFERENCE An informal conference has been scheduled with OSHA to discuss the citation(s) issued on 8/14/2023. . ‘The conference will be held at the OSHA office located at Division of Occupational Safety and Health, 1101 Mail Service Center, Raleigh, NC 276990n__.__at__-_. Employees and/or representatives of employees have a right to attend an informal conference, Gatton and Notieation of Penalty Page 6 of 2 ‘OSHA (Rev I/14)North Carolina Department of Labor Occupational Safety and Health Division 1101 Mail Service Center Raleigh, NC 27699 Phone: 919-779-8570 FAX: 919-420-7966 Request for Abatement Date Extensions In the event it becomes necessary fo request an extension of the abatement date for any violation listed on the enclosed citation(s), certain information must be submitted, in writing, before this request can be considered, Please send your request to: ‘North Carolina Department of Labor Occupational Safety and Health Division 1101 Mail Service Center Raleigh, NC 27699 ‘The Division of Occupational Sefety and Health has the authority to approve or deny any request for abatement extension, However, this approval or denial will not be exercised until the expiration of fifteen (15) working days from the date your employees were notified of the request for an extension. ‘This notification will be accomplished by posting the enclosed "Request for Abatement Date Extension” or by delivering notice to an authorized employee representative, During this fifteen (15) working days period, you are responsible for assuring the safety and health of your employees in the area of the cited hazard Attached to this letter is the information you need to include with your request for an extension of any abatement date, Please answer each item completely and forward to this office as soon as it becomes apparent that an extension will be necessary. if you have any questions regarding this procedure, please call our office at:919-779-8570, Citation end Notification of Penalty Page 7 of 2 ‘OSHA (Rev 1/14)Mn ‘The employer must indicate in the boxes below which item(s) of the Citation and Notification of Penalty it wishes to extend, First, the employer most identify the citation and item number(s). (For example, "Citation 1, Item 2" or 1-24") Then the employer must indicate all actions taken, their dates, to achieve compliance during the original abatement period. The employer must also include: the specific additional time necessary, the reasons for the additional time, all available interim steps being taken to safeguard employees, a cortification that a copy of this PMA hes beon posted and served upon the authorized employee representative, and the date the posting and service was completed. Request for Abatement Date Extension Inspection Number SHO ID Issuance Date 318265741 LU73 8/14/2023 Employer's name and mailing address Cape Fear Habitat for Humanity, Inc, 3310 Fredrickson Road Wilmington, NC 28401 Citation and | Abatement Date | Anticipated | Reason for requesting an | Interim steps taken to safeguard | Ktomno. | onCiation | Completion | additonal abatement | employees, including dates, Date period during any extended sbatement i perlod aaa ‘The employer completing this form must sign the form, Name of Employer Representative, Title Phone Signature Date Citation end Notification of Penalty Page 8 of 12 ‘OSHA-2 (Rev 1/14)Certificate of Posting Thereby certify that the Request for Abatement Date Extension form and this Certificate of Posting were posted as required on 20, , and a copy furnished to the authorized employee representative, Hf appropriate, and will remain posted for a period of 15 working days, If any affected employees, or their representative, feel that this extension should ‘not be granted, they should file an objection to the request in writing to: North Carolina Department of Labor Occupational Safety and Health Division 1101 Mail Service Center Raleigh, NC 27699 ‘The Division of Occupational Safety and Health has the authority to approve or deny any request for abatement extension, However, this approval or denial will not be exercised until the expiration of fifteen (15) working days from the date your employees were notified of the request for an extension, ‘This notification will be accomplished by posting the enclosed "Request for Abatement Dete Extension" or by delivering notice to an authorized employee representative. During this fifteen (15) working days period, you are responsible for assuring the safety and health of your employees in the area of the cited hazard. Failure to file such objection within fifteen (15) working days of the date of posting of the petition shall constitute a waiver of any further right to object to the petition, Company Name Authorized Signature Date A copy of this Certificate of Posting must be retumed with your request for abatement extension, Cittion and Notification of Penalty aged of 12 ‘OSHA-2 (Rev 1/14)North Carolina Department of Labor Inspection Number: 318265741 Occupational Safety and Health Division Inspection Date(s): 5/16/2023 Issuance Date: 8/14/2023 Citation and Notification of Penalty Company Name: Cope Fear Habitat for Humanity, Inc, Inspection Site: 7330 Market Street, Wilmington, NC 28411 Citation 01 Item 001 ‘Type of Violation; Serious 29 CFR 1910.176(b): Storage of material created a hazard: 8) building supply warehiouse ~ where 25-inch x 14-inch laminate countertops weighing approximately 120 pounds each were stored vertically and held in specific bays by shop-made dividers which could not hold the weight of the countertops. On or about May 12, 2023 an employee was fatally injured when a divider failed and a stack of countertops fell onto the employee. Date By Which Violation Must Be Abate Immediately Upon Receipt Proposed Penalty: $7,812.50 Giation and Notification of Penally Page 10 of 12 OSHA (Rev 1714)North Carolina Department of Labor Inspection Number: 318265741 ‘Occupational Safety and Health Division Inspection Date(s): $/16/2023 Issuance Date: 8/14/2023 Citation and Notification of Penalty Company Name: Cape Fear Habitat for Humanity, Inc. Inspection Site: 7330 Market Street, Wilmington, NC 28411 Citation 02 Item 001 ‘Type of Violation: NonSerious 29 CFR 1904.39(a)(1); The employer did not report to OSHA within eight (8) hours after the death of ‘an employee as a result of a work-related incident: 4) building supply warehouse — where the employer was alerted to the death of an employee from a work-related accident on May 13, 2023 but did not report the fatality to OSHA until May 15, 2023, Date By Which Violation Must Be Abated: Corrected During Inspection Proposed Penalty: $3,000.00 fet Supervinpr for the Director Gitation and Notification of Penalty Page li oF 12 ‘OSHA (Rev i714)-North Carolina Department of Labor Occupational Safety and Health Division 1101 Mail Service Center Raleigh, NC 27699 Phone: 919-779-8570 FAX: 919-420-7966 INVOICE/ DEBT COLLECTION NOTICE Company Name: Cape Feat Habitat for Humanity, Inc, Inspection Site: 7330 Market Street, Wilmington, NC 28411 Issuance Date: 8/14/2023, Summary of Penalties for Inspection Number: 318265741 Citation 1, Serious = $7,812.50 Citation 2, NonSerious = $3,000.00 TOTAL PENALTIES = $10,812.50 yayment promptly to Attn: Financial Services Division « Collections, NC Department of © Labor at 1101 Mail Service Center, Raleigh, NC 27699-1101, for the total amount of the uncontested penalties summarized above, Make your check or money order payable to: NC Department of Labor, OSHA Division. For payment by credit card, complete the form provided. Please indicate OSHA's Inspection Number (indicated above) on the remittance, Pay online at www.labor.nc.gov We accept VISA, MasterCard, and E-Checks, You may also fax your payment to (919) 715-9094, or mail to: N.C. Department of Labor, Financial Services Division, 1101 Mail Service Center, Raleigh, NC 27699-1101, OSHA does not agree to any restrictions or conditions or endorsements put on any check or money order for less than full emount due, and will cash the check or money order as if these restrictions, conditions, or endorsements do not exist, ‘Gltation and Notification of Penalty Pago 12 of 12 OSHA-2 (Rev 1/14)Ted Hendrix CONFIRMATION OF ABATEMENT RETURN THIS FORM TO: NORTH CAROLINA DEPARTMENT OF LABOR Occupational Safety and Health Division 1101 Mall Service Center Raleigh, NC 27699 919-779-8570 FAILURE TO RESPOND BY THE DUE DATE MAY RESULT IN A FOLLOW-UP INSPECTION DATE FORM DUE: Immediately upon Receipt FILE NO; 318265741 COMPANY: Cape Fear Habitat for Humanity, Inc. LOCATION: 7330 Market Street, Wilmington, NC 26411 ‘THE ALLEGED VIOLATIONS LISTED BELOW THAT WERE OBSERVED ON THE 5/16/2023 OSHA INSPECTION BY THE NORTH CAROLINA DEPARTMENT OF LABOR WERE CORRECTED ON OR BEFORE ‘THE FOLLOWING ABATEMENT DATE: Immediately upon Receipt XTeM STANDARD OR REGULATION _ ACTION TAKEN TO CORRECT VIOLATION NUMBER ‘ALLEGEDLY VIOLATED {attach additional pages if needed) Giation 01 Item 001 1930.176(b) *©* To be acceptable the Action Taken To Correct Violation must be described in detall, Photos or other evidence of abatement may be attached, ‘THE UNDERSIGNED ATTEST THAT THE ABOVE ITEMS WERE CORRECTED ON OR BEFORE THE PRESCRIBED ABATEMENT DATE: SIGNATURI TM: DATE: 1363900 aoe Sea zoaineue