Inspection Detail

Inspection: 1500362 - Formwork Services Inc

Inspection Information - Office: Denver Area Office

Inspection Nr: 1500362

Report ID: 0830500

Date Opened: 11/19/1984

Site Address:
Formwork Services Inc
425 W Prospect (Holiday Inn)
Fort Collins, CO 80526

Mailing Address:
1780 S Bellaire St Suite 802, Denver, CO 80222

Union Status: NonUnion

SIC:1771

NAICS: 0

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 12/14/1984

Planning Guide: Safety-Construction

Emphasis:

Case Closed: 02/04/1985

Related Activity
Type	Activity Nr	Safety	Health
Accident	360554752

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1					1
Current Violations	1					1
Initial Penalty	$200	$0	$0	$0	$0	$200
Current Penalty	$200	$0	$0	$0	$0	$200
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	19260500 B08	01/04/1985	01/08/1985	$200	$200	$0		-

Investigation Summary

Investigation Nr: 14507099

Event: 11/16/1984

Employee killed in 8 ft fall when floor collapses

Employee #1 was inspecting the stripping of forms on the 8th floor of a building. He had just observed the stripping of 4 ft by 8 ft by 3/4 in. plywood forms that had most of their shoring removed and that lacked supports to hold the 4 ft by 8 ft sheets of plywood in place. Employee #1 climbed a ladder to the 9th floor, 8 ft above the 8th floor, and stepped onto this plywood. Two sheets of plywood collapsed with his second step. Employee #1 fell to the 8th floor, landing on his face. He was killed. Paramedics reported that his death was caused by cardiac arrest due to trauma. He reportedly did not attempt to break his fall. Employee #1 was the general foreman for the subcontractor, Form Work Services, Inc.

Keywords: COLLAPSE, UNSECURED, WORK RULES, CONSTRUCTION, CARDIAC ARREST, WALKING SURFACE, FALL, FACE, INATTENTION

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	1500362			Fatality	Other	Occupation not reported

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