Inspection Detail

Inspection: 300860897 - Master Design Inc

Inspection Information - Office: San Bernardino District Office

Inspection Nr: 300860897

Report ID: 0950633

Date Opened: 01/16/2003

Site Address:
Master Design Inc
1900 S Burgundy Place
Ontario, CA 91761

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:2511

NAICS: 337122/Nonupholstered Wood Household Furniture Manufacturing

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 01/16/2003

Emphasis:

Case Closed: 04/30/2003

Related Activity
Type	Activity Nr	Safety	Health
Accident	362456436

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				1		1
Current Violations				1		1
Initial Penalty	$0	$0	$0	$560	$0	$560
Current Penalty	$0	$0	$0	$560	$0	$560
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	Other	3650 S02	04/21/2003	04/24/2003	$560	$560	$0		-

Investigation Summary

Investigation Nr: 300860897

Event: 11/22/2002

Employee Suffers Amputation of Toe

At approximately 11:45 a.m. on November 22, 2002, Employee #1 was working as a warehouse man and was unloading and unpacking boxes of furniture adjacent to truck door Number 31 between racks 25 and 26 at the warehouse. Employee #1 observed the forklift moving in his direction and stated that he had eye contact with the forklift operator. However, Employee #1's foot was struck and ran over by a wheel of the stand-up Raymond electric forklift, Model: EASI DR30TT, Number 3000. Employee #1 sustained the amputation of the little toe of his right foot and was hospitalized.

Keywords: AMPUTATED, INDUSTRIAL TRUCK, STRUCK BY, TOE, FOOT

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	300860897			Hospitalized injury	Amputation	Laborers, except construction

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