Inspection Detail

Inspection: 304613995 - Form & Structure Inc

Inspection Information - Office: Or-E-Portland - Safety 1 1054111

Inspection Nr: 304613995

Report ID: 1054112

Date Opened: 07/16/2001

Site Address:
Form & Structure Inc
10708 Ne 2nd Ave
Portland, OR 97211

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:1751

NAICS: 0

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 09/13/2001

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 09/09/2002

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			1		2
Current Violations	1			1		2
Initial Penalty	$500	$0	$0	$500	$0	$1,000
Current Penalty	$500	$0	$0	$100	$0	$600
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.	01001A	Serious	701076001 A	10/03/2001	10/20/2001	$500	$500	$0	10/15/2001	L - State Settlement
2.	01001B	Serious	701076001 B C	10/03/2001	10/13/2001	$0	$0	$0	10/15/2001	L - State Settlement	Citation has been deleted.
3.	01001C	Serious	19100213 C02	10/03/2001	10/13/2001	$0	$0	$0	10/15/2001	L - State Settlement
4.	01001D	Serious	19100213 C03	10/03/2001	10/13/2001	$0	$0	$0	10/15/2001	L - State Settlement
5.	02002	Other	7010052	10/03/2001	07/16/2001	$100	$500	$0	10/15/2001	L - State Settlement

Investigation Summary

Investigation Nr: 201632106

Event: 07/10/2001

Cabinet maker injured hand in saw

On July 10, 2001, Employee #1, a cabinet maker, was pulling a 3.5-in.-wide by 0.75-in.-thick by 6-ft-long piece of finished oak board through a table saw that was being used to rip cut 1/2 in. from the width of the board. Employee #1 sustained partial amputation of two fingers and serious lacerations on two other fingers on his left hand which required hospitalization.

Keywords: AMPUTATED, FINGER, SAW, LACERATION, TABLE SAW

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	304613995			Hospitalized injury	Amputation	Occupation not reported

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