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Get CA OSHAB Appeal Form 100 2014

___________________ Inspection Number on Citation ____________ (Leave blank-Appeals Board will fill in.) __________________________________ Employer Name on Citation 1. You only have 15 working days from receipt of a citation to appeal. __________________________________ Employer Legal Name or DBA (Optional) 2. A copy of this form must be attached to each citation or notification appealed. Failure to file a completed form may result in dismissal of the appeal. ____________________________.

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