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Inspection Detail
Inspection: 106793565 - Cap Form, Incorporated
Inspection Information - Office: Dallas Area Office
Site Address:
Cap Form, Incorporated
13546 North Central Expressway
Dallas, TX 75243
Mailing Address:
P. O. Box 111130, Carrollton, TX 75011
Union Status: NonUnion
SIC:1799
NAICS: 0
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 10/28/1992
Planning Guide: Safety-Construction
Emphasis:
Case Closed: 06/28/1993
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 360891774 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 3 | 3 | ||||
| Current Violations | ||||||
| Initial Penalty | $12,000 | $0 | $0 | $0 | $0 | $12,000 |
| Current Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| FTA Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| # | Citation ID | Citaton Type | Standard Cited | Issuance Date | Abatement Due Date | Current Penalty | Initial Penalty | FTA Penalty | Contest | Latest Event | Note |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | 01001A | Serious | 5A0001 | 11/04/1992 | 11/09/1992 | $4,000 | $4,000 | $0 | 11/16/1992 | F - Formal Settlement | Citation has been deleted. |
| 2. | 01001B | Serious | 19260028 A | 11/04/1992 | 11/09/1992 | $0 | $0 | $0 | 11/16/1992 | F - Formal Settlement | Citation has been deleted. |
| 3. | 01002 | Serious | 19260020 B01 | 11/04/1992 | 12/24/1992 | $4,000 | $4,000 | $0 | 11/16/1992 | F - Formal Settlement | Citation has been deleted. |
| 4. | 01003 | Serious | 19260021 B02 | 11/04/1992 | 12/24/1992 | $4,000 | $4,000 | $0 | 11/16/1992 | F - Formal Settlement | Citation has been deleted. |
Investigation Summary
Employee #1, a 37-year-old labor foreman, was wrecking wooden forms over an elevator shaft opening. He was standing on the wooden forms, which consisted of multiple 2 by 10s, 4 by 6s, and a 2 by 12. He was removing the nails and cutting the boards when the formwork collapsed, causing him to fall 18 ft through the opening and land on the concrete floor of the shaft. Employee #1 was killed.
Keywords: CONCRETE FORM WORK, WORK RULES, ELEVATOR SHAFT, DISMANTLING, COLLAPSE, CONSTRUCTION, UNSTABLE SURFACE, FALL
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 106793565 | Fatality | Other | Occupation not reported |