Inspection Detail

Inspection: 106502495 - Dorn'S Delivery & Transfer, Inc.

Inspection Information - Office: Appleton Area Office

Inspection Nr: 106502495

Report ID: 0521100

Date Opened: 01/15/1992

Site Address:
Dorn'S Delivery & Transfer, Inc.
2316 W. Everett St.
Appleton, WI 54914

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:4213

NAICS: 0

Inspection Type: Accident

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 01/21/1992

Emphasis:

Case Closed: 08/24/1992

Related Activity
Type	Activity Nr	Safety	Health
Accident	361105422

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	5					5
Current Violations	5					5
Initial Penalty	$4,350	$0	$0	$0	$0	$4,350
Current Penalty	$3,150	$0	$0	$0	$0	$3,150
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	19100178 L	02/07/1992	03/26/1992	$1,500	$1,500	$0	I - Informal Settlement
2.	01002	Serious	19100178 M05 III	02/07/1992	02/12/1992	$1,500	$1,500	$0	I - Informal Settlement
3.	01003	Serious	19101200 E01	02/07/1992	03/26/1992	$50	$450	$0	I - Informal Settlement
4.	01004	Serious	19101200 G08	02/07/1992	03/26/1992	$50	$450	$0	I - Informal Settlement
5.	01005	Serious	19101200 H	02/07/1992	03/26/1992	$50	$450	$0	I - Informal Settlement

Investigation Summary

Investigation Nr: 845198

Event: 01/13/1992

Employee crushed and killed between forklift guard and box

Employee #1 was found standing with his head pinned between the upright overhead guard on a Clark forklift (model #C-500-S 60, serial #355-450-4381, 6,000 lb capacity), and a box of plastic pellets. He was killed. The forklift was in gear but the parking brake was not set.

Keywords: HEAD, BRAKE, UNSECURED, PINNED, CAUGHT BETWEEN, INDUSTRIAL TRUCK

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	106502495			Fatality	Asphyxia	Occupation not reported

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