Inspection Detail
Inspection: 120164439 - Sure Forming Systems Inc
Inspection Information - Office: Santa Ana District Office
Site Address:
Sure Forming Systems Inc
2000 State College Blvd
Anaheim, CA 92800
Mailing Address:
10602 Humbolt St, Los Alamitos, CA 92806
Union Status: Union
SIC:1799
NAICS: 0
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 02/04/1997
Planning Guide: Safety-Construction
Emphasis:
Case Closed: 12/02/1997
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 362225153 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $4,500 | $0 | $0 | $0 | $0 | $4,500 |
| Current Penalty | $0 | $0 | $0 | $125 | $0 | $125 |
| 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. | 01001 | Other | 1670 C | 03/07/1997 | 03/12/1997 | $125 | $4,500 | $0 | 04/11/1997 | F - Formal Settlement |
Investigation Summary
Employee #1, a laborer, was removing a beam from the top of some falsework. He was standing on the outside portion of the falsework near a small wall at the edge of a floor level when the beam dislodged. Employee #1 and the beam fell 16 ft to the next lower level. He suffered a compound fracture of his left leg.
Keywords: ERECTION PROCESS, FRACTURE, WORK RULES, CONSTRUCTION, FALL, FALL PROTECTION, LEG
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 120164439 | Hospitalized injury | Fracture | Construction trades, n.e.c. |
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