Inspection Detail

Inspection: 125907881 - Adair Roofing

Inspection Information - Office: Santa Ana District Office

Inspection Nr: 125907881

Report ID: 0950631

Date Opened: 05/08/1997

Site Address:
Adair Roofing
2390 North American Way St
Orange, CA 92668

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:1761

NAICS: 0

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 05/08/1997

Emphasis:

Case Closed: 01/18/2000

Related Activity
Type	Activity Nr	Safety	Health
Accident	362225260

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	4			2		6
Current Violations	4			2		6
Initial Penalty	$4,965	$0	$0	$260	$0	$5,225
Current Penalty	$4,965	$0	$0	$260	$0	$5,225
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
1.	01001	Other	342 A	08/22/1997	08/27/1997	$175	$175	$0		W - Empr Withdrew
2.	01002	Other	3203 A	08/22/1997	09/09/1997	$85	$85	$0	07/03/1998	W - Empr Withdrew
3.	02001	Serious	3657 A03	08/22/1997	09/09/1997	$655	$655	$0	07/03/1998	W - Empr Withdrew
4.	03001	Serious	3657 D	08/22/1997	08/27/1997	$655	$655	$0	07/03/1998	W - Empr Withdrew
5.	04001	Serious	3657 A	08/22/1997	09/09/1997	$655	$655	$0	07/03/1998	W - Empr Withdrew
6.	05001	Serious	3657 A02	08/22/1997	08/27/1997	$3,000	$3,000	$0	07/03/1998	W - Empr Withdrew

Investigation Summary

Investigation Nr: 170167555

Event: 03/03/1997

Employee killed when work platform falls from forklift

Employee #1 was working atop a platform elevated approximately 10 ft by a forklift. The unsecured platform came off the forklift, causing him to fall. Employee #1 suffered a fractured skull and was pronounced dead at the scene.

Keywords: FRACTURE, UNSECURED, WORK RULES, CONSTRUCTION, INDUSTRIAL TRUCK, SKULL, FALL, ELEVATED WORK PLAT

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	125907881			Fatality	Fracture	Occupation not reported

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