Inspection Detail

Inspection: 125751396 - Prime Source

Inspection Information - Office: American Canyon District Office

Inspection Nr: 125751396

Report ID: 0950622

Date Opened: 03/27/2001

Site Address:
Prime Source
250 Dittmer Road
Fairfield, CA 94533

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:4225

NAICS: 0

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 03/27/2001

Emphasis:

Case Closed: 06/28/2001

Related Activity
Type	Activity Nr	Safety	Health
Accident	362089765

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				2		2
Current Violations				2		2
Initial Penalty	$0	$0	$0	$600	$0	$600
Current Penalty	$0	$0	$0	$600	$0	$600
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	342 A	04/12/2001	03/27/2001	$400	$400	$0		-
2.	01002	Other	3216 B	04/12/2001	05/15/2001	$200	$200	$0		-

Investigation Summary

Investigation Nr: 201483922

Event: 09/21/2000

Employee killed when run over by a fork lift truck

At approximately 12:00 p.m. on September 21, 2000, Employee # 1 was standing in the yard where particle board is stored. A forklift operator had just set down some particle boards when Employee #1 walked into the yard and stopped and looked down. The fork lift operator looked back, but did not see Employee #1 and backed the fork lift over him. Employee #1 was hospitalized with a dislocated right foot and abrasions to his right leg, left foot, and left knee.

Keywords: KNEE, PINNED, CRUSHED, INDUSTRIAL TRUCK, ABRASION, DISLOCATED, STRUCK BY, RUN OVER, FOOT, LEG

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	125751396			Hospitalized injury	Dislocation	Sales workers, hardware and building supplies

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