Abstract: At approximately 8:30 a.m. on March 1, 1991, Employee #1, an experienced maintenance worker, was coming down a portable wooden extension ladder from a 10 ft 8 in. high canopy roof. He placed one foot on the third rung from the top of the ladder and was trying to place his other foot on the rung when the ladder slipped and he fell to the wet asphalt floor. Employee #1 suffered serious head injuries from striking the back of his head on the floor when first landing; he died later that same day. The extended length of the ladder was 13 ft, and its highest standing level was 9 ft 9 in. The ladder was not long enough to use with a 10 ft 8 in. high roof and still provide 3 ft extended side-rails over the roof level. In addition, the ladder did not have an anti-skid base and no one was holding it to keep it from slipping. The employer was cited for one general and one serious violation.