Inspection Detail

Case Status: CLOSED

Inspection: 1484533.015 - Standard Of Beaverdale

Inspection Information - Office: Iowa

Inspection Nr: 1484533.015

Report ID: 0751910

Date Opened: 07/21/2020

Site Address:
Standard Of Beaverdale
11194 Twin Ponds Dr.
West Burlington, IA 52655

Mailing Address:
11194 Twin Ponds Dr., West Burlington, IA 52655

Union Status: NonUnion

SIC:

NAICS: 423310/ Lumber, Plywood, Millwork, and Wood Panel Merchant Wholesalers

Inspection Type: Fat/Cat

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 07/21/2020

Emphasis:

Case Closed: 12/18/2020

Related Activity
Type	Activity Nr	Safety	Health
Accident	1626755

Case Status: CLOSED

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	2					2
Current Violations	2					2
Initial Penalty	$11,366	$0	$0	$0	$0	$11,366
Current Penalty	$11,366	$0	$0	$0	$0	$11,366
FTA Penalty	$0	$0	$0	$0	$0	$0

Violation Items
#	Citation ID	Citaton Type	Standard Cited	Issuance Date	Abatement Due Date	Current Penalty	Initial Penalty	FTA Penalty	Contest	Latest Event	Note
1.	01001	Serious	19260451 C02 V	11/19/2020	01/08/2021	$5,683	$5,683	$0		Z - Issued
2.	01002	Serious	19100178 M05 I	11/19/2020	01/08/2021	$5,683	$5,683	$0		Z - Issued

Investigation Summary

Investigation Nr: 127970.015

Event: 07/20/2020

Employee Falls From Elevated Forklift Box Platform And Is Ki

At 4:30 p.m. on July 20, 2020, an employee was in the process of removing broken branches from trees located on the property. The employee had a coworker raise him up in a wood box that was being used as a personnel basket. Using a CASE (Mo del Number 580 "G" Series) Forklift, the coworker then raised the box up the req uired height determined by the employee. The coworker was then directed by the employee to move her car. When the coworker reached her car, she heard a crash. When she looked up, she saw the employee lying on the ground with the wood box o n top of him. The employee was killed by a wood box that was approximately 4 fe et wide by 4 feet high, by 4 feet deep.

Keywords:elevated work platform, fall, forklift, struck by

Investigated Inspection
#	Inspection	Age	Sex	Degree	Nature	Occupation
1	1484533.015			Fatality		Supervisors, n.e.c.

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DEPARTMENT OF LABOR

Occupational Safety and Health Administration OSHA