Inspection Detail

Inspection: 307337113 - Costco Wholesale

Inspection Information - Office: Oakland District Office

Inspection Nr: 307337113

Report ID: 0950614

Date Opened: 04/07/2005

Site Address:
Costco Wholesale
40580 Albrae Street
Fremont, CA 94538

Mailing Address:
999 Lake Drive, Issaquah, WA 98027

Union Status: NonUnion

SIC:5399

NAICS: 452910/Warehouse Clubs and Supercenters

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: LocalGovt

Safety/Health: Safety

Close Conference: 05/13/2005

Emphasis:

Case Closed: 06/28/2006

Related Activity
Type	Activity Nr	Safety	Health
Accident	361628563

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			1		2
Current Violations	1			1		2
Initial Penalty	$18,000	$0	$0	$5,000	$0	$23,000
Current Penalty	$2,700	$0	$0	$5,000	$0	$7,700
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.	01001	Other	342 A	05/23/2005	05/26/2005	$5,000	$5,000	$0		I - Informal Settlement
2.	02001	Serious	3203 A	05/23/2005	05/26/2005	$2,700	$18,000	$0		I - Informal Settlement

Investigation Summary

Investigation Nr: 201505492

Event: 03/25/2005

Employee Suffers Fractured Face When Struck by Pole

A coworker was using the forks of a forklift to remove four bolts holding down a 77-in.-high and 48-in.-long galvanized steel "T-Pole". During this process, Employee #1 was standing approximately four feet to six feet away counting inventory on a pallet. As the coworker used the tips of the forklift to shear off the floor-mounted bolts, the "T-pole" popped up and rotated to the right of the forklift and hit Employee #1 on the right side of his face as he looked up to see what was causing the noise. Employee #1 suffered a fracture and was hospitalized.

Keywords: FRACTURE, COLUMN, INDUSTRIAL TRUCK, BOLT, STRUCK BY, FACE

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	307337113			Hospitalized injury	Fracture	Supervisors, personal service occupations

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