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Inspection Detail
Inspection: 126131424 - Sure Forming Systems Inc.
Inspection Information - Office: Monrovia District Office
Site Address:
Sure Forming Systems Inc.
Pomona College, 170 E.6th St.
Claremont, CA 91711
Mailing Address:
10602 Humbolt St, Los Alamitos, CA 90720
Union Status: Union
SIC:1751
NAICS: 0
Inspection Type: Accident
Scope: Complete
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 12/07/1998
Emphasis:
Case Closed: 04/26/1999
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 362622698 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 3 | 3 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $0 | $0 | $0 | $1,650 | $0 | $1,650 |
| Current Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| 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 | Other | 1513 A | 12/07/1998 | 12/31/1998 | $0 | $550 | $0 | 01/20/1999 | F - Formal Settlement | |
| 2. | 01002 | Other | 1712 C01 | 12/07/1998 | 12/31/1998 | $0 | $550 | $0 | 01/20/1999 | F - Formal Settlement | Citation has been deleted. |
| 3. | 01003 | Other | 3203 B02 | 12/07/1998 | 12/31/1998 | $0 | $550 | $0 | 01/20/1999 | F - Formal Settlement | Citation has been deleted. |
Investigation Summary
At approximately 10:30 a.m. on June 26, 1998, Employee #1, of Sure Forming Systems, Inc., was on an extension ladder installing rods in the top panels of a wall at a construction site in Claremont, CA. He was descending when he fell between 16 and 18 ft to the ground, suffering a head injury that required hospitalization for a week. Employee #1 later stated that he did not remember why he fell, but that there were no tools or materials on the ladder and that the ladder itself did not fall to the ground.
Keywords: HEAD, EXTENSION LADDER, INSTALLING, LADDER, CONSTRUCTION, DESCENDING, FALL
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 126131424 | Hospitalized injury | Concussion | Carpenters |