Inspection Detail

Inspection: 120318340 - John Mcloud

Inspection Information - Office: Van Nuys District Office

Inspection Nr: 120318340

Report ID: 0950643

Date Opened: 06/14/2004

Site Address:
John Mcloud
28529 Conejo View Drive
Agoura Hills, CA 91301

Mailing Address:
820 Thompson Ave # 19, Glendale, CA 91201

Union Status: NonUnion

SIC:1761

NAICS: 238390/Other Building Finishing Contractors

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 09/30/2004

Emphasis: S:Construction (Cship)

Case Closed: 10/21/2006

Related Activity
Type	Activity Nr	Safety	Health
Accident	362524084

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			1		2
Current Violations	1			1		2
Initial Penalty	$3,150	$0	$0	$350	$0	$3,500
Current Penalty	$3,150	$0	$0	$350	$0	$3,500
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	Other	1735 O	09/30/2004	10/26/2004	$350	$350	$0		-
2.	02001	Serious	1670 A	09/30/2004	10/15/2004	$3,150	$3,150	$0		-

Investigation Summary

Investigation Nr: 201117645

Event: 04/20/2004

Employee injures low back in fall from roof

At 9:00 a.m. on April 20, 2004, Employee #1 was removing old plywood on the flat roof of the 8-ft 4-in. high carport. While carrying a piece of plywood and walking toward to the dumpster, which was placed next to the carport, Employee #1 lost his balance and fell off at the edge of the roof to the concrete floor. Employee #1 sustained the low back pain and was taken to the Thousand Oaks Hospital. He was hospitalized for three days.

Keywords: ROOF, CONSTRUCTION, DUMPSTER, BACK, FALL, LOST BALANCE, CONCRETE

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	120318340			Hospitalized injury	Bruise/Contus/Abras	Construction laborers

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