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Inspection Detail
Inspection: 125556415 - Intex Forms, Inc.
Inspection Information - Office: Fremont District Office
Site Address:
Intex Forms, Inc.
1011 Timothy Drive
San Jose, CA 95133
Mailing Address:
, , 00000
Union Status: NonUnion
SIC:2221
NAICS: 0
Inspection Type: Accident
Scope: Complete
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 01/21/1999
Emphasis:
Case Closed: 05/26/2000
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 101793347 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 3 | 9 | 12 | |||
| Current Violations | 3 | 9 | 12 | |||
| Initial Penalty | $6,860 | $0 | $0 | $1,775 | $0 | $8,635 |
| Current Penalty | $6,860 | $0 | $0 | $1,775 | $0 | $8,635 |
| 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 | 6151 C04 | 02/04/1999 | 02/21/1999 | $160 | $160 | $0 | - | ||
| 2. | 01002 | Other | 3578 G | 02/04/1999 | 02/21/1999 | $160 | $160 | $0 | - | ||
| 3. | 01003 | Other | 3577 E | 02/04/1999 | 02/21/1999 | $0 | $0 | $0 | - | ||
| 4. | 01004 | Other | 5162 C | 02/04/1999 | 02/21/1999 | $160 | $160 | $0 | - | ||
| 5. | 01005 | Other | 14301 A01 | 02/04/1999 | 02/13/1999 | $325 | $325 | $0 | - | ||
| 6. | 01006 | Other | 342 A | 02/04/1999 | 02/09/1999 | $325 | $325 | $0 | - | ||
| 7. | 01007 | Other | 3203 B01 | 02/04/1999 | 02/21/1999 | $325 | $325 | $0 | - | ||
| 8. | 01008 | Other | 25100058 A | 02/04/1999 | 02/21/1999 | $160 | $160 | $0 | - | ||
| 9. | 01009 | Other | 3314 G | 02/04/1999 | 02/21/1999 | $160 | $160 | $0 | - | ||
| 10. | 02001 | Serious | 4000 D | 02/04/1999 | 02/21/1999 | $1,125 | $1,125 | $0 | - | ||
| 11. | 03001 | Serious | 4300 A | 02/04/1999 | 02/21/1999 | $110 | $110 | $0 | - | ||
| 12. | 04001 | Serious | 4002 B | 02/04/1999 | 02/21/1999 | $5,625 | $5,625 | $0 | - |
Investigation Summary
Employee #1 was given the job assignment to mix gypsum and plaster while using an electric powered mixer. Employee #1 attached the blade with a screw to the shaft. A five-gallon bucket would be placed on the mixers base and Employee #1 would pour plaster into the five-gallon bucket and start the machine. While reaching up to turn off the machine, his glove became caught on the protruding screw, causing his finger to be twisted and amputated. Employee #1 was wearing gloves to protect his hands from drying out from the plaster. Employee #1 called out for help and was later transported by employees to a nearby hospital and hospitalized.
Keywords: AMPUTATED, FINGER, GLOVE, MIXER, CAUGHT BY
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 125556415 | Hospitalized injury | Amputation | Laborers, except construction |