Accident Report Detail
Accident Summary Nr: 89082.015 - Employee is struck and killed by concrete form
| Inspection Nr | Date Opened | SIC | NAICS | Establishment Name |
|---|---|---|---|---|
| 1180481.015 | 09/28/2016 | 238120 | Jr Concrete Construction Inc. |
Abstract: At approximately 9:00 a.m. on September 28, 2016, Employee #1 was preparing a 300 pound concrete column form and stepped inside it to modify it. The column fell over, struck Employee #1 who then struck his head on the concrete surface. Employee #1 fractured his head and was killed.
| End Use | Project Type | Project Cost | Stories | Non-building Height | Fatality | ||
|---|---|---|---|---|---|---|---|
| Multi-family dwelling | New project or new addition | $5,000,000 to $20,000,000 | 1 | X | |||
| Employee # | Inspection Nr | Age | Sex | Degree of Injury | Nature of Injury | Occupation | Construction |
|---|---|---|---|---|---|---|---|
| 1 | 1180481.015 | 45 | M | Fatality | Concrete and terrazzo finishers | Distance of Fall: feet Worker Height Above Ground/Floor: 4 feet Cause: Forming Fatality Cause: |
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