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Inspection Detail
Inspection: 125616193 - Hollern Construction, Inc.
Inspection Information - Office: American Canyon District Office
Site Address:
Hollern Construction, Inc.
12651 Sir Frances Drake Boulevard
Inverness, CA 94937
Mailing Address:
P.O. Box 822, Pt. Reyes Station, CA 94956
Union Status: NonUnion
SIC:1521
NAICS: 0
Inspection Type: Accident
Scope: Complete
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 08/17/2000
Planning Guide: Safety-Construction
Emphasis: S:Lead In Construction
Case Closed: 05/25/2001
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 361592389 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 2 | ||||
| Current Violations | 2 | 2 | ||||
| Initial Penalty | $11,700 | $0 | $0 | $0 | $0 | $11,700 |
| Current Penalty | $1,800 | $0 | $0 | $0 | $0 | $1,800 |
| 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 | 15410001 A01 | 08/28/2000 | 08/28/2000 | $900 | $900 | $0 | 09/14/2000 | F - Formal Settlement | |
| 2. | 02001 | Serious | 1637 A | 08/28/2000 | 08/28/2000 | $900 | $10,800 | $0 | 09/14/2000 | F - Formal Settlement |
Investigation Summary
Employee #1 and coworkers were using a concrete pump with a 3 in. diameter hose to pour concrete into a retaining wall at a single-family home under construction. They were working in shifts, back and forth across the top of the formwork wall. One coworker was carrying the nozzle of the hose, with Employee #1 approximately 10 ft behind him; another coworker was 10 ft behind Employee #1, walking on an earthen bank. Employee #1 fell 16 ft from the top of the form onto a concrete slab, landing on his back and striking his head on the pump hose. He was hospitalized for fractured vertebrae and a concussion. The work platform was not 20 in. wide and no scaffold was provided.
Keywords: CONCRETE FORM WORK, FRACTURE, HEAD, WORK RULES, CONSTRUCTION, BACK, FALL, CONCUSSION, ELEVATED WORK PLAT, VERTEBRA
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 125616193 | Hospitalized injury | Concussion | Carpenters |