Translate
Inspection Detail
Inspection: 1350505.015 - Capform, Inc.
Inspection Information - Office: Fort Worth Area Office
Site Address:
Capform, Inc.
724 Stadium Dr.
Arlington, TX 76011
Mailing Address:
1455 Halse Way, Carrollton, TX 75007
Union Status: NonUnion
SIC:
NAICS: 238110/Poured Concrete Foundation and Structure Contractors
Inspection Type: Referral
Scope: Complete
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 10/01/2018
Emphasis:
Case Closed: 12/28/2018
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Referral | 1386853 | Yes |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 2 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $25,868 | $0 | $0 | $0 | $0 | $25,868 |
| Current Penalty | $0 | $0 | $0 | $6,000 | $0 | $6,000 |
| 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 | 19100178 L01 | 12/03/2018 | 01/02/2019 | $0 | $12,934 | $0 | I - Informal Settlement | Citation has been deleted. | |
| 2. | 01002 | Other | 19260021 B02 | 12/03/2018 | 01/02/2019 | $6,000 | $12,934 | $0 | I - Informal Settlement |
Investigation Summary
At 8:15 a.m. on September 29, 2018, an employee was working to dismantle concrete tower forms. While working, a portion of the form structure fell over and struck the employee who was hospitalized with unspecified injuries.
Keywords: Collapse, Concrete Form Work, Dismantling, Fall, Falling Object, Struck By, Structural Collapse
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1350505.015 | 42 | M | Hospitalized injury | Construction laborers |