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Inspection Detail
Inspection: 125479089 - International Surfacing Systems
Inspection Information - Office: American Canyon District Office
Site Address:
International Surfacing Systems
1941 Adobe Road
Penngrove, CA 94951
Mailing Address:
Po Box 4770, Modesto, CA 95352
Union Status: NonUnion
SIC:1611
NAICS: 237310/ Highway, Street, and Bridge Construction
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 09/08/2010
Planning Guide: Safety-Construction
Emphasis: L:Arrastim, S:Construction (Cship)
Case Closed: 01/21/2012
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 102646627 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $18,000 | $0 | $0 | $0 | $0 | $18,000 |
| Current Penalty | $4,500 | $0 | $0 | $0 | $0 | $4,500 |
| 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 | Serious | 1592 E | 09/08/2010 | 09/13/2010 | $4,500 | $18,000 | $0 | 09/21/2010 | F - Formal Settlement |
Investigation Summary
On June 10, 2010, Employee #1, a superintendent of International Surfacing Systems, was supervising highway surface repairs. While inspecting the road surface, Employee #1 was run over by a dump truck that was backing up. This resulted in serious injury to his pelvis and back.
Keywords: BACK, DUMP TRUCK, PELVIS, STRUCK BY, RUN OVER, BACKING UP
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 125479089 | Hospitalized injury | Fracture | Supervisors, motor vehicle operators |