Inspection Detail
Inspection: 306271750 - Avery Dennison
Inspection Information - Office: Springfield Area Office
Site Address:
Avery Dennison
One Better Way
Chicopee, MA 01022
Mailing Address:
, , 00000
Union Status: Union
SIC:2678
NAICS: 322233/ Stationery, Tablet, and Related Product Manufacturing
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 01/05/2004
Emphasis: L:Forklift
Case Closed: 03/30/2004
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 100690478 | ||
| Referral | 200696516 | Yes |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 2 | ||||
| Current Violations | 2 | 2 | ||||
| Initial Penalty | $6,875 | $0 | $0 | $0 | $0 | $6,875 |
| Current Penalty | $5,875 | $0 | $0 | $0 | $0 | $5,875 |
| 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. | 01001A | Serious | 19100176 C | 01/16/2004 | 02/18/2004 | $5,000 | $5,000 | $0 | - | ||
| 2. | 01001B | Serious | 19100144 A02 | 01/16/2004 | 01/22/2004 | $0 | $0 | $0 | I - Informal Settlement | Citation has been deleted. | |
| 3. | 01002 | Serious | 19100178 P01 | 01/16/2004 | 01/22/2004 | $875 | $1,875 | $0 | I - Informal Settlement |
Investigation Summary
On October 30, 2003, Employee #1 died of blunt head trauma after he fell onto a concrete floor, while exiting a stand on a fork lift.
Keywords: HEAD, INDUSTRIAL TRUCK, CONCRETE
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 306271750 | Fatality | Concussion | Freight, stock and material handlers, n.e.c. |
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