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Inspection Detail
Inspection: 1411026.015 - C And K Form Fabrication, Inc.
Inspection Information - Office: American Canyon District Office
Site Address:
C And K Form Fabrication, Inc.
3839 Bithell Lane
Suisun City, CA 94585
Mailing Address:
333 East F. St, P O Box 430, Colton, CA 92324
Union Status: Union
SIC:
NAICS: 423310/ Lumber, Plywood, Millwork, and Wood Panel Merchant Wholesalers
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 11/25/2019
Emphasis:
Case Closed: 06/21/2021
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 1468618 | ||
| Inspection | 1411044 | Yes |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 2 | 3 | |||
| Current Violations | 1 | 1 | 2 | |||
| Initial Penalty | $14,400 | $0 | $0 | $625 | $0 | $15,025 |
| Current Penalty | $7,200 | $0 | $0 | $250 | $0 | $7,450 |
| 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 | 3203(B)(2) | 11/25/2019 | $250 | $250 | $0 | 12/20/2019 | O - Administrative Law Judge Order | ||
| 2. | 01002 | Other | 3203(A)(4) | 11/25/2019 | $0 | $375 | $0 | 12/20/2019 | O - Administrative Law Judge Order | Citation has been deleted. | |
| 3. | 02001 | Serious | 3273(A) | 11/25/2019 | $7,200 | $14,400 | $0 | 12/20/2019 | O - Administrative Law Judge Order |
Investigation Summary
At 12:30 p.m. on June 20, 2019, Employee #1 was cutting wooden materials in a mill yard. He was using a miter saw to cut wood to the size while standing on a piece of plywood as a platform. The plywood measured 4 feet long by 4 feet wide by 0.25 inch high. Employee #1 unplugged a 50-foot extension cord from the miter saw so that he could return it to another location. While holding the cord, he turned around when the plywood he was standing on rocked between his feet. As he continued to walk with his right leg, which was his pivot foot, he heard his right foot "pop" and he fell to the ground. Employee #1 sustained a broken right femur for which he was hospitalized and had surgery.
Keywords: Fall, Fracture, Leg, Platform, Plywood, Work Surface
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1411026.015 | 27 | M | Hospitalized injury | Laborers, except construction |