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Inspection Detail
Inspection: 1496025.015 - Wa317960819 - Jakes Fireworks Inc
Inspection Information - Office: Dosh Tumwater Service Location, Tumwater, Wa
Site Address:
Wa317960819 - Jakes Fireworks Inc
739 Nevil Rd
Winlock, WA 98596
Mailing Address:
% Lonestar Management Llc 1500 E 27th Terrace, Pittsburg, KS 66762
Union Status: NonUnion
SIC:
NAICS: 424690/Other Chemical and Allied Products Merchant Wholesalers
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 11/06/2020
Emphasis: P:Hosp, S:Hosp
Case Closed: 01/18/2023
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 1669539 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 1 | 3 | |||
| Current Violations | 2 | 1 | 3 | |||
| Initial Penalty | $10,800 | $0 | $0 | $3,600 | $0 | $14,400 |
| Current Penalty | $8,600 | $0 | $0 | $0 | $0 | $8,600 |
| 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 | 296-869-20045(4) | 12/02/2020 | 08/26/2020 | $5,600 | $7,200 | $0 | 04/13/2021 | F - Formal Settlement | |
| 2. | 01002 | Other | 296-800-16010 | 12/02/2020 | 01/04/2021 | $0 | $3,600 | $0 | 04/13/2021 | F - Formal Settlement | |
| 3. | 01003 | Serious | 296-800-14005 | 12/02/2020 | 01/04/2021 | $3,000 | $3,600 | $0 | 04/13/2021 | F - Formal Settlement |
Investigation Summary
At 10:50 p.m. on August 25, 2020, the manager reported that employee had been hospitalized and was undergoing surgery due to blunt force trauma to the head after falling 10 - 12 feet from an order picker onto the concrete floor. The employee died as a result of his injuries on August 26, 2020.
Keywords: Blunt force, Blunt force trauma, Concrete, Fall, Head, Order-picker
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1496025.015 | 34 | M | Fatality | Occupation not reported |