Accident Report Detail

Accident Summary Nr: 200461739 - Employee Falls from Ladder Jack Scaffold and is Killed

Accident Summary Nr: 200461739 -- Report ID: 0111400 -- Event Date: 04/07/2004
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
306811829	04/07/2004	1761	238160	Payge Roofing

Abstract: Employee #1 fell 23 feet from a ladder jack scaffold and was killed.

Keywords: LADDER JACK SCAFFOLD, FALL

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Single family or duplex dwelling		Alteration or rehabilitation		Under $50,000	2		X

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	306811829			Fatality	Other	Occupation not reported	Distance of Fall: feet Worker Height Above Ground/Floor: 23 feet Cause: Roofing Fatality Cause: Fall from/with scaffold

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