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Inspection Detail
Inspection: 1550342.015 - C & K Form Fabrications
Inspection Information - Office: American Canyon District Office
Site Address:
C & K Form Fabrications
3839 Bithell Lane
Suisun City, CA 94585
Mailing Address:
3839 Bithell Lane, Suisun City, CA 94585
Union Status: Union
SIC:
NAICS: 332312/Fabricated Structural Metal Manufacturing
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 02/24/2022
Emphasis:
Case Closed: 08/24/2026
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 1802881 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | 2 | |||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $14,400 | $0 | $0 | $500 | $0 | $14,900 |
| Current Penalty | $9,500 | $0 | $0 | $0 | $0 | $9,500 |
| FTA Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| # | Citation ID | Citation Type | Standard Cited | Issuance Date | Abatement Due Date | Current Penalty | Initial Penalty | FTA Penalty | Contest | Latest Event | Note |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | 01001 | Other | 3203(A)(7)(D) | 02/24/2022 | $0 | $500 | $0 | 04/20/2022 | O - Administrative Law Judge Order | Citation has been deleted. | |
| 2. | 02001 | Serious | 3328(A)(2) | 02/24/2022 | $9,500 | $14,400 | $0 | 04/20/2022 | O - Administrative Law Judge Order |
Investigation Summary
At 7:00 a.m. on August 24, 2021, an employee working as a machine operator for a manufacturer of fabricated structures was working on wood products to meet client specifications. The employee was using an electric Milwaukee Heavy Duty Compact Hole Shooter to drill 1.5-inch diameter holes on a 14-inch square by 5.5-inch-thick wood blocks. The employee was standing on an 11-inch-high elevated platform while operating the hole shooter. The employee lost control of the equipment when the drill rotated and caused the employee to fall to the concrete. The employee was hospitalized to treat a broken kneecap requiring surgery. He was released on the same day of the surgery and recovered at home.
Keywords: Broken Bone, Concrete Floor, Drill, Drilling, Elevated Work Platform, Equipment Operator, Fall, Fall From Elevation, Fall Protection, Fracture, Hand Tool, Hole, Injury Illness Prevention Program, Knee, Lack of Work Procedures, Lost Balance, Lost Control, Machine Guarding, Machine operator, Material Handling, Platform, Raised platform, Wood Board
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1550342.015 | 60 | M | Hospitalized injury | Hand molding, casting, and forming occupations |