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• <br /> Oregon Department of Consumer and Business Services <br /> Oregon Occupational Safety and Health Division (OR- OSHA) <br /> 1140 Willagillespie <br /> Eugene, OR 97401 tFf/ <br /> Phone: (541)686 -7562 <br /> INVOICE/ <br /> DEBT COLLECTION NOTICE <br /> Company Name: City of Eugene <br /> Inspection Site 300 N Jefferson St, Eugene, OR 97401 <br /> Issuance Date: 04/23/96 <br /> Summary of Penalties for Inspection Number 126248301 <br /> Citation 1, Serious = $ 180.00 <br /> Citation 2, Other = $ 0.00 <br /> ��i :A:#. ,. , •,.-- :::: ---.. ,'.,. ,i�. •.. .. - '• : ,, �,,,,.'. i: :i: ?.?:S i iiii: 4iiiii }�i:.iry:.iiii }i:.;.- „.,.,., ,.� <br /> RETURN COPY OF INVOICE WITH PAYMENT <br /> Oregon Revised Statutes, Chapter 654, the Oregon Safe Employment Act, Subsection 654.086(3) states: "When <br /> an order assessing a civil penalty becomes fmal by operation of law or an appeal, unless the amount of penalty is <br /> paid within 10 days after the order becomes fmal, it constitutes a judgment and may be filed with the county clerk <br /> in any county of this state. The clerk shall thereupon record the name of the person incurring the penalty and the <br /> amount of the penalty in the judgment docket. The penalty provided in the order so docketed shall become a lien <br /> upon the title to any interest in property owned by the person against whom the order is entered, and execution <br /> upon a judgment of a court or record.” <br /> To avoid additional charges, please remit payment promptly to Department of Consumer & Business Services, • <br /> Fiscal Services Section, Labor & Industries Building, 350 Winter St NE, Salem, Oregon 97310, for the total <br /> amount of the uncontested penalties summarized above. Make your check or money order payable to: <br /> "DEPARTMENT OF CONSUMER & BUSINESS SERVICES." Please indicate the Inspection Number (printed <br /> above) on the remittance and return a copy of this invoice with payment. <br /> Mail your payment to: DEPARTMENT OF CONSUMER & BUSINESS SERVICES <br /> Fiscal Services Section - OR -OSHA <br /> Labor & Industries Building <br /> 350 Winter St NE <br /> Salem OR 97310 <br /> Employer ID #: 5723077 -023 Fiscal use only 51101 0345 <br /> Company Name: City of Eugene <br /> Opt Rpt Num: M8412- 048 -96 <br /> Region ID #: 1054114 <br /> Page 1 of 1 <br />