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Inspection Detail
Inspection: 302533633 - Sam'S Club 6386
Inspection Information - Office: Concord Area Office
Site Address:
Sam'S Club 6386
Rt. 106
Concord, NH 03301
Mailing Address:
304 Sheep Davis Rd., Concord, NH 03301
Union Status: NonUnion
SIC:5399
NAICS: 0
Inspection Type: Complaint
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 01/26/1999
Emphasis:
Case Closed: 04/03/2000
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Complaint | 200609832 | Yes |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 2 | 3 | |||
| Current Violations | 2 | 1 | 3 | |||
| Initial Penalty | $1,625 | $0 | $17,500 | $0 | $0 | $19,125 |
| Current Penalty | $3,250 | $0 | $0 | $200 | $0 | $3,450 |
| 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 | Serious | 19100178 Q07 | 03/12/1999 | 04/14/1999 | $1,625 | $1,625 | $0 | 04/06/1999 | F - Formal Settlement | |
| 2. | 02001 | Serious | 19100178 P01 | 03/12/1999 | 03/17/1999 | $1,625 | $10,000 | $0 | 04/06/1999 | F - Formal Settlement | |
| 3. | 02002 | Other | 19100305 G01 III | 03/12/1999 | 03/17/1999 | $200 | $7,500 | $0 | 04/06/1999 | F - Formal Settlement |
Investigation Summary
Employee #1, age 18, was operating a Crown pallet rider forklift while a coworker was operating a standup forklift nearby at a Sam's Club store in Concord, NH. Employee #1 was headed toward the coworker at a 45 degree angle, just as the coworker was backing away from depositing a load. The coworker's vehicle had its forks pointed toward Employee #1 as the coworker began to move it forward. Employee #1 raised his foot off the accelerator to activate his brakes, but the brakes failed and he could not stop. A fork of the coworker's standup forklift impaled Employee #1's right lower leg, resulting in a 2 in. to 3 in. deep puncture wound just below his knee.
Keywords: IND TRK OPERATOR, BRAKE, IMPALED, EQUIPMENT FAILURE, COLLISION, INDUSTRIAL TRUCK, MECH MAT HANDLING, WALK-BEHIND FORKLIFT, LEG, PUNCTURE
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 302533633 | Hospitalized injury | Puncture | Industrial truck and tractor equipment operators |