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Accident Summary Nr: 201044336 - One Employee Is Killed, One Is Bruised in Forklift Tip Over

Accident Summary Nr: 201044336 -- Report ID: 0953220 -- Event Date: 12/28/2009
Inspection NrDate OpenedSICNAICSEstablishment Name
31396963612/28/20091629237130Selbach Construction

Abstract: On December 28, 2009, Employee #1 and Employee #2 were working in a basket of an all terrain forklift at a height of approximately 40 ft. The forklift tipped over. Employee #1 was killed and Employee #2 was hospitalized with bruises and contusions.

Keywords: STRUCK AGAINST, INDUSTRIAL TRUCK, FALL, CONTUSION, OVERTURN
Accident Details
End Use Project Type Project Cost Stories Non-building Height Fatality
Other heavy construction New project or new addition Under $50,000 50 X

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation Construction
1 313969636 Hospitalized injury Bruise/Contus/Abras Occupation not reported Distance of Fall: feet
Worker Height Above Ground/Floor: 42 feet
Cause: Fencing, installing lights, signs, etc.
Fatality Cause: Fall from/with scaffold
2 313969636 Fatality Bruise/Contus/Abras Occupation not reported Distance of Fall: feet
Worker Height Above Ground/Floor: 42 feet
Cause: Fencing, installing lights, signs, etc.
Fatality Cause: Fall from/with scaffold

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