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Inspection Detail
Inspection: 302684808 - State Farm Mutual Automobile Insurance Co
Inspection Information - Office: Or-E-Salem 1054100
Site Address:
State Farm Mutual Automobile Insurance Co
4600 25th Avenue Ne
Salem, OR 97313
Mailing Address:
, , 00000
Union Status: NonUnion
SIC:6331
NAICS: 0
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 02/14/2000
Planning Guide: Safety-Manufacturing
Emphasis:
Case Closed: 11/24/2000
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 101612281 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 3 | 3 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $8,000 | $0 | $0 | $0 | $0 | $8,000 |
| Current Penalty | $750 | $0 | $0 | $0 | $0 | $750 |
| 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 | 702022307 G | 03/02/2000 | 03/07/2000 | $0 | $5,000 | $0 | 03/17/2000 | L - State Settlement | Citation has been deleted. |
| 2. | 01002 | Serious | 702022317 | 03/02/2000 | 03/07/2000 | $0 | $1,500 | $0 | 03/17/2000 | L - State Settlement | Citation has been deleted. |
| 3. | 01003 | Serious | 19100178 L03 IM | 03/02/2000 | 03/07/2000 | $750 | $1,500 | $0 | 03/17/2000 | L - State Settlement |
Investigation Summary
At approximately 9:00 a.m. on December 17, 1999, Employee #1 died instantly as he tried to escape from an overturning fork lift. He picked up an empty pallet in the warehouse area and traveled across the yard. Apparently, he turned the fork lift sharply causing it to overturn. Employee #1 tried to jump off the fork lift as it was falling over; however, the fall over protection structure hit him. He died instantly.
Keywords: EJECTED, ASPHYXIATED, INDUSTRIAL TRUCK, OVERTURN
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 302684808 | Fatality | Asphyxia | Industrial truck and tractor equipment operators |