Inspection Detail

Case Status: CLOSED

Inspection: 1614914.015 - American Custom Metal Fabricating, Inc.

Inspection Information - Office: Appleton Area Office

Inspection Nr: 1614914.015

Report ID: 0521100

Date Opened: 08/16/2022

Site Address:
American Custom Metal Fabricating, Inc.
2612 S. Broadway St.
Green Bay, WI 54303

Mailing Address:
2612 S. Broadway St., Green Bay, WI 54303

Union Status: NonUnion

SIC:

NAICS: 332312/Fabricated Structural Metal Manufacturing

Inspection Type: Fat/Cat

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 08/16/2022

Emphasis: L:Piv

Case Closed: 03/16/2023

Related Activity
Type	Activity Nr	Safety	Health
Accident	1934642
Referral	1930826	Yes

Case Status: CLOSED

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1					1
Current Violations	1					1
Initial Penalty	$6,340	$0	$0	$0	$0	$6,340
Current Penalty	$6,340	$0	$0	$0	$0	$6,340
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.	01001A	Serious	19100028 B11 II	01/13/2023	03/13/2023	$6,340	$6,340	$0		Z - Issued
2.	01001B	Serious	19100029 F01 I	01/13/2023	03/13/2023	$0	$0	$0		Z - Issued

Investigation Summary

Investigation Nr: 148848.015

Event: 08/11/2022

Employee falls while walking down stairs, later dies

At 12:00 noon on July 29, 2022, an employee was walking from his work area to the back parking area while on break when he stumbled, fell down the stairs, and struck his head on a hard surface. There were no witnesses of the fall incident. The stairway was made up of six risers, enclosed on both sides, 48 inches wide, and made of concrete, with one steel pipe handrail on the right side descending. Upon discovery, the employee was transported to the local hospital and died in the hospital 13 days later.

Keywords: Blunt force, Blunt force trauma, Fall, Fall From Elevation, Head, Stair, Struck Against, Walking Surface

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	1614914.015	65	M	Fatality		Machinists

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