Inspection Detail

Inspection: 108175605 - San Antonio Forming (U.S.) Inc

Inspection Information - Office: Arizona Division Of Occupational Safety And Health (Adosh)

Inspection Nr: 108175605

Report ID: 0950411

Date Opened: 02/22/1990

Site Address:
San Antonio Forming (U.S.) Inc
19 W Palm Lane
Phoenix, AZ 85003

Mailing Address:
2425 E Thomas Suite #14, Phoenix, AZ 85016

Union Status: NonUnion

SIC:1751

NAICS: 0

Inspection Type: Planned

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 02/23/1990

Planning Guide: Safety-Construction

Emphasis:

Case Closed: 09/25/1990

Related Activity
Type	Activity Nr	Safety	Health
Accident	360188700

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			1		2
Current Violations	1					1
Initial Penalty	$640	$0	$0	$0	$0	$640
Current Penalty	$320	$0	$0	$0	$0	$320
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	Contest	Latest Event	Note
1.	01001	Serious	19260500 B08	04/09/1990	04/12/1990	$320	$640	$0	05/03/1990	F - Formal Settlement
2.	02001	Other	19260025 A	04/09/1990	04/12/1990	$0	$0	$0	05/03/1990	F - Formal Settlement	Citation has been deleted.

Investigation Summary

Investigation Nr: 170065247

Event: 02/15/1990

Employee injured in fall through floor hole

Employee #1 was clearing a path for a cart loaded with sprinkler pipes, and moved a piece of plywood that he apparently thought was scrap. The plywood was actually an unmarked floor hole cover held in place by 16-penny nails driven through the plywood around the concrete inside the perimeter of the opening. Employee #1 fell through the opening, struck his head on the 13th floor, then landed on the 12th floor. He sustained serious head and shoulder injuries. The unmarked cover was surrounded by debris and easily moved by picking it up.

Keywords: HEAD, COVER, SHOULDER, FALL, FLOOR OPENING, UNSECURED, WORK RULES, STRUCK AGAINST, CONSTRUCTION

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	108175605					Occupation Not Listed

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