Inspection Detail

Inspection: 307330993 - Carl W Lebengood & Roland J Theiss

Inspection Information - Office: Medford

Inspection Nr: 307330993

Report ID: 1054116

Date Opened: 09/16/2004

Site Address:
Carl W Lebengood & Roland J Theiss
396 Coarse Gold Rd
Winston, OR 97496

Mailing Address:
Po Box 824, Myrtle Creek, OR 97457

Union Status: NonUnion

SIC:4225

NAICS: 531130/Lessors of Miniwarehouses and Self-Storage Units

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 11/04/2004

Planning Guide: Safety-Construction

Emphasis:

Case Closed: 04/19/2005

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	6					6
Current Violations	6					6
Initial Penalty	$4,600	$0	$0	$0	$0	$4,600
Current Penalty	$1,550	$0	$0	$0	$0	$1,550
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
1.	01001	Serious	19260451 F15	12/08/2004	12/13/2004	$500	$2,500	$0	01/03/2005	L - State Settlement
2.	01002A	Serious	19260451 F03	12/08/2004	12/25/2004	$250	$500	$0	01/03/2005	L - State Settlement
3.	01002B	Serious	19260454 A	12/08/2004	12/25/2004	$0	$0	$0	01/03/2005	L - State Settlement
4.	01003A	Serious	19260452 W02	12/08/2004	12/13/2004	$250	$500	$0	01/03/2005	L - State Settlement
5.	01003B	Serious	19260452 B09	12/08/2004	12/13/2004	$0	$0	$0	01/03/2005	L - State Settlement
6.	01003C	Serious	19260451 B01	12/08/2004	12/13/2004	$0	$0	$0	01/03/2005	L - State Settlement
7.	01003D	Serious	19260451 E01	12/08/2004	12/13/2004	$0	$0	$0	01/03/2005	L - State Settlement
8.	01004	Serious	19261060 A	12/08/2004	12/13/2004	$250	$500	$0	01/03/2005	L - State Settlement
9.	01005	Serious	19261053 B16	12/08/2004	12/13/2004	$150	$300	$0	01/03/2005	L - State Settlement
10.	01006	Serious	703050301 A	12/08/2004	12/13/2004	$150	$300	$0	01/03/2005	L - State Settlement

Investigation Summary

Investigation Nr: 201621737

Event: 09/14/2004

Two Employees Are Injured in Fall From Elevation

Employees #1 and #2 were installing siding to the exterior of a building. They were using two tubular welded scaffolds with an extension ladder on top of each scaffold. They were at the top of the ladders at a height of approximately 18 feet when one of the scaffolds tipped over. Both employees fell from their ladders, landing on the ground. Employees #1 and #2 sustained multiple fractures and were hospitalized.

Keywords: FRACTURE, EXTENSION LADDER, INSTALLING, BUILDING, FALL, TUBULAR SCAFFOLD

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	307330993			Hospitalized injury	Fracture	Occupation not reported
2	307330993			Hospitalized injury	Fracture	Occupation not reported

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