Abstract: At approximately 11:30 a.m. on September 13, 2008, Employees #1, #2, and #3 were instructed by the employers' managers to work together and clean with a pressure washer cooler Number 3. Employee #1 operated a propane powered Nissan Enduro 50 forklift. He lifted Employee #2 on a pallet on the forks of the forklift, to gain access to the walls and ceiling for pressure washing. The propane and gasoline powered pressure washer was placed in a refrigeration cooler, while Employees #1 and #2 were working. The cooler dimensions were 30-ft wide by 65-ft long, by 15-ft high. Employee #3 was on the ground sweeping, picking up debris, and removing stains from the floor of the cooler. Employees #1 and #2 felt ill and Employee #3 began shaking severely. Employees #1 and #2 helped Employee #3 to leave the cooler. Employees #1, #2, and #3 were taken to the County University of South Carolina, where they were evaluated for overexposure to carbon monoxide. Employees #1, #2, and #3 were later taken to a hyperbaric chamber in Long Beach for treatment for carbon monoxide exposure and released the same day. The manager did not provide any training on the proper use of the pressure washer. Employees #1 and #2 were also not provided with training on forklift operations, although they both operate the forklift on a daily basis.