Inspection Detail

Inspection: 306604711 - J M Manufacturing Co Inc

Inspection Information - Office: Bend

Inspection Nr: 306604711

Report ID: 1054115

Date Opened: 06/30/2004

Site Address:
J M Manufacturing Co Inc
31240 Roxbury Rd
Umatilla, OR 97882

Mailing Address:
Corporation Service Company 285 Liberty St Ne, Salem, OR 97301

Union Status: NonUnion

SIC:3089

NAICS: 326122/Plastics Pipe and Pipe Fitting Manufacturing

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 07/13/2004

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 12/21/2004

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1					1
Current Violations	1					1
Initial Penalty	$500	$0	$0	$0	$0	$500
Current Penalty	$400	$0	$0	$0	$0	$400
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	701076005	07/30/2004	08/04/2004	$400	$500	$0	08/11/2004	L - State Settlement
2.	01001B	Serious	701076001 B A	07/30/2004	08/04/2004	$0	$0	$0	08/11/2004	L - State Settlement

Investigation Summary

Investigation Nr: 201701695

Event: 06/27/2004

Employee Is Injured When Pinned by Forklift

At about 9:30 p.m. on June 27, 2004, Employee #1 was attempting to turn off the propane feed valve to a forklift while it was backing up. He crouched down behind the forklift in a position where the forklift operator could not see him. Employee #1 became pinned between the forklift counterweight and an "I" shaped building column. After being initially treated at Good Shepherd Medical Center, Employee #1 was hospitalized at Emmanuel Hospital in Portland for treatment of fractured ribs and a severely bruised heart.

Keywords: HEART, FRACTURE, PINNED, COLUMN, INDUSTRIAL TRUCK, SHUT-OFF VALVE, PROPANE, COMMUNICATION, BACKING UP, INATTENTION

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	306604711			Hospitalized injury	Bruise/Contus/Abras	Extruding and forming machine operators

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