Inspection Detail

Inspection: 125533901 - Yardbirds

Inspection Information - Office: American Canyon District Office

Inspection Nr: 125533901

Report ID: 0950615

Date Opened: 10/12/2005

Site Address:
Yardbirds
1801 4th Street
San Rafael, CA 94901

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:5211

NAICS: 444110/Home Centers

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 01/13/2006

Emphasis:

Case Closed: 04/24/2006

Related Activity
Type	Activity Nr	Safety	Health
Accident	101020212

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				2		2
Current Violations				2		2
Initial Penalty	$0	$0	$0	$750	$0	$750
Current Penalty	$0	$0	$0	$750	$0	$750
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	3203 A04	01/17/2006	01/20/2006	$450	$450	$0		-
2.	01002	Other	3664 A	01/17/2006	01/20/2006	$300	$300	$0		-

Investigation Summary

Investigation Nr: 170839385

Event: 10/11/2005

Employee's Pelvis Is Fractured When Struck by Forklift

At approximately 7:00 a.m., on October 11, 2005, Employee #1 was taking a smoke break, when she was struck by a Hyster S59XM fork lift. An operator was backing the heavily laden forklift out of the building department area through the rear roll-up doorway. The operator observed Employee #1 as she stood adjacent to the building department rear doorway. While backing towards her, the operator was unable to stop before striking her. She was pinned between the forklift and the building wall. She was hospitalized with a fractured pelvis at Marin General Hospital.

Keywords: BACK-UP ALARM, BRAKE, SPEEDING, WORK RULES, INDUSTRIAL TRUCK, INEXPERIENCE, SMOKING, STRUCK BY, BACKING UP, INATTENTION

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	125533901			Hospitalized injury	Fracture	Industrial truck and tractor equipment operators

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