Inspection Detail

Inspection: 125719864 - Pacific Pizza Inc/Round Table Pizza

Inspection Information - Office: Modesto District Office

Inspection Nr: 125719864

Report ID: 0950624

Date Opened: 05/11/2004

Site Address:
Pacific Pizza Inc/Round Table Pizza
2405 Pacific Avenue
Stockton, CA 95204

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:5812

NAICS: 722211/Limited-Service Restaurants

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 06/18/2004

Emphasis:

Case Closed: 05/31/2007

Related Activity
Type	Activity Nr	Safety	Health
Accident	362340853

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1					1
Current Violations	1					1
Initial Penalty	$17,500	$0	$0	$0	$0	$17,500
Current Penalty	$2,700	$0	$0	$0	$0	$2,700
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	Serious	4544 B	06/18/2004	05/11/2004	$2,700	$17,500	$0	07/19/2004	F - Formal Settlement

Investigation Summary

Investigation Nr: 201104817

Event: 12/21/2003

Employee is injured in pizza dough roller

At approximately 1:00 p.m. on December 21, 2003, Employee #1 was folding boxes at a pizza parlor. Since the boxes were stacked near the pizza dough roller, she asked a coworker, the pizza dough roller operator, to get some boxes down for her. As the operator turned to retrieve the boxes, Employee #1 reached into the dough roller, past the dough brake, and reached the rollers. Her right hand became caught between the rollers and she sustained degloving injuries to her right hand and forearm and was hospitalized.

Keywords: ROLLER--MACH/PART, CAUGHT BETWEEN, SKIN, ARM, HAND

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	125719864			Hospitalized injury	Bruise/Contus/Abras	Miscelaneous food preparation occupations

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