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Inspection Detail
Inspection: 1419301.015 - Jack Walters And Sons Corp
Inspection Information - Office: Appleton Area Office
Site Address:
Jack Walters And Sons Corp
N1364 Phister Ln.
Kiel, WI 53042
Mailing Address:
6600 Midland Ct., Allenton, WI 53002
Union Status: NonUnion
SIC:
NAICS: 238130/Framing Contractors
Inspection Type: Referral
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 07/30/2019
Emphasis: L:Piv
Case Closed: 11/08/2019
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Referral | 1481344 | Yes |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $13,127 | $0 | $0 | $0 | $0 | $13,127 |
| Current Penalty | $7,876 | $0 | $0 | $0 | $0 | $7,876 |
| 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 | 5A0001 | 10/18/2019 | 11/18/2019 | $7,876 | $13,127 | $0 | I - Informal Settlement |
Investigation Summary
At 5:08 p.m. on July 26, 2019, Employee # 1 was lifting a wood truss with a rough terrain forklift. He elevated and extended the boom to lift the truss high enough to clear the wall of the building as he was backing up to move the lift perpendicular to the building. Employee # 1 backed the lift across the slope causing the forklift to rollover. He was pinned between the forklift and the ground. Employee #1 suffered an amputation of one finger and a laceration to the head. He was hospitalized.
Keywords: Amputated, Amputation, Boom, Finger, Forklift, Laceration, Lift, Pinned, Roll-Over, Truss
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1419301.015 | 61 | M | Hospitalized injury | Carpenters |