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Inspection Detail
Inspection: 300854619 - Pacific Supply Co
Inspection Information - Office: Santa Ana District Office
Site Address:
Pacific Supply Co
3134 W Westhaven
Anaheim, CA 92808
Mailing Address:
675 N Batavia, Orange, CA 92868
Union Status: NonUnion
SIC:5211
NAICS: 0
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 06/04/2002
Planning Guide: Safety-Manufacturing
Emphasis:
Case Closed: 04/18/2003
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 362357907 | ||
| Accident | 362357923 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | ||||||
| Initial Penalty | $0 | $0 | $0 | $500 | $0 | $500 |
| Current Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| 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 | Other | 3999 F | 06/14/2002 | 06/19/2002 | $0 | $500 | $0 | 07/15/2002 | F - Formal Settlement | Citation has been deleted. |
Investigation Summary
At approximately 11:00 a.m. on March 13, 2002, Employee #1 was a part of a three-man team delivering roofing material. The team, including Employee #1, was driving a truck equipped with a material handling conveyor to the delivery site. A coworker, the truck driver, backed the truck into the driveway of the house and elevated the conveyor to rest its top end on the ridge of the roof. Before the conveyor was stable, Employee #1 started to walk up the belt of it to get to the roof. When Employee #1 neared the roof, the conveyor shifted and he fell 14 ft to he ground. Employee #1 suffered a back injury and was taken to UCI Medical Center for treatment, where he was hospitalized.
Keywords: DELIVERY WORK, ROOF, BACK, TRUCK, CONVEYOR, FALL
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 300854619 | Hospitalized injury | Other | Laborers, except construction |