Inspection Detail

Inspection: 301278701 - Route 66 Roofing

Inspection Information - Office: High Hazard Unit - South

Inspection Nr: 301278701

Report ID: 0950662

Date Opened: 01/07/2004

Site Address:
Route 66 Roofing
4320 Cedar Creek Dr
Yorba Linda, CA 92688

Mailing Address:
20125 Rendal Dr, San Bernardino, CA 92407

Union Status: NonUnion

SIC:1761

NAICS: 238160/Roofing Contractors

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 04/15/2004

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 01/10/2006

Related Activity
Type	Activity Nr	Safety	Health
Accident	101691871

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1					1
Current Violations				1		1
Initial Penalty	$5,060	$0	$0	$0	$0	$5,060
Current Penalty	$0	$0	$0	$450	$0	$450
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	3203 A	04/15/2004	04/22/2004	$450	$5,060	$0	08/26/2004	F - Formal Settlement

Investigation Summary

Investigation Nr: 201691813

Event: 12/18/2003

Employee receives injuries from fall off of roof

At approximately 9:45 a.m. on December 18, 2003, Employee #1 was installing an eave riser on the edge of a roof. He used a batten to support himself at the edge of the roof. As he was installing the eave, he lost his balance and fell 10-ft from the second story roof to the first story roof. He struck the first story roof and fell another 10-ft to the ground. The impact of the multiple falls fractured his left wrist and bruised his back, chest, and neck. After being taken to the hospital, he received medical treatment and postoperative care for which he was hospitalized.

Keywords: CHEST, FRACTURE, ROOF, BACK, FALL, FALL PROTECTION, NECK, LOST BALANCE, CONTUSION, WRIST

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	301278701			Hospitalized injury	Fracture	Roofers

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