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Inspection Detail
Inspection: 126066943 - Sure Forming System
Inspection Information - Office: Long Beach District Office
Site Address:
Sure Forming System
24501 South Figueroa Street
Carson, CA 90745
Mailing Address:
10602 Humblolt St, Los Alamitos, CA 90720
Union Status: Union
SIC:1771
NAICS: 0
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 02/04/2000
Emphasis:
Case Closed: 08/17/2004
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 362400749 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 2 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $10,000 | $0 | $0 | $0 | $0 | $10,000 |
| Current Penalty | $0 | $0 | $0 | $500 | $0 | $500 |
| 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 | 1548 A | 02/08/2000 | 02/28/2000 | $0 | $5,000 | $0 | 03/29/2000 | J - ALJ Decision | Citation has been deleted. |
| 2. | 02001 | Other | 1670 A | 02/08/2000 | 02/28/2000 | $500 | $5,000 | $0 | 03/29/2000 | J - ALJ Decision |
Investigation Summary
At approximately 1:30 p.m. on November 18, 1999, Employee #1, a carpenter, was hanging a plumb bob on a concrete form high above the ground. His hands slipped and he fell about 12 ft, landing in a concrete hopper. Employee #1 suffered a contusion on his head and was transported by Los Angeles County paramedics to Harbor General Hospital, where he remained for five days. As his release, he was treated as an outpatient and underwent therapy.
Keywords: CONCRETE FORM WORK, HEAD, CARPENTER, WORK RULES, SLIP, CONSTRUCTION, CLIMBING ON COLUMN, FALL, FALL PROTECTION, CONTUSION
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 126066943 | Hospitalized injury | Bruise/Contus/Abras | Carpenters |