Inspection Detail

Inspection: 102515921 - Don'S Repair & Machine Corp.

Inspection Information - Office: Madison Area Office

Inspection Nr: 102515921

Report ID: 0523300

Date Opened: 04/23/1991

Site Address:
Don'S Repair & Machine Corp.
251 W. Adams
Lake Delton, WI 53940

Mailing Address:
P.O. Box 188, Lake Delton, WI 53940

Union Status: NonUnion

SIC:3599

NAICS: 0

Inspection Type: Accident

Scope: Partial

Advanced Notice: Y

Ownership: Private

Safety/Health: Safety

Close Conference: 05/23/1991

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 08/05/1991

Related Activity
Type	Activity Nr	Safety	Health
Accident	360117857

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			3		4
Current Violations	1			3		4
Initial Penalty	$750	$0	$0	$0	$0	$750
Current Penalty	$375	$0	$0	$0	$0	$375
FTA Penalty	$0	$0	$0	$0	$0	$0

Violation Items
#	Citation ID	Citaton Type	Standard Cited	Issuance Date	Abatement Due Date	Current Penalty	Initial Penalty	FTA Penalty	Latest Event
1.	01001	Serious	5A0001	06/12/1991	06/15/1991	$375	$750	$0	I - Informal Settlement
2.	02001	Other	19100147 C01	06/12/1991	07/31/1991	$0	$0	$0	I - Informal Settlement
3.	02002	Other	19101200 E01	06/12/1991	07/31/1991	$0	$0	$0	I - Informal Settlement
4.	02003	Other	19101200 H01	06/12/1991	07/31/1991	$0	$0	$0	I - Informal Settlement

Investigation Summary

Investigation Nr: 14499453

Event: 04/16/1991

STRUCK BY

DECEASED WAS STRUCK BY FLATBED SEMI-TRAILER RAMP WHICH WAS BEING HELP UP BY HOIST WHEN THE HOIST CHAIN CAME UNHOOKED AND DROPPED THE RAMP. EMPLOYEE WAS UNDER THE LOAD ADJUSTING A PIVOT PIN.

Keywords: CHAIN, RAMP, WORK RULES, STRUCK BY, FALLING OBJECT, INATTENTION

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	102515921			Fatality	Fracture	Occupation not reported

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