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Inspection Detail

Inspection: 307425793 - The Fall Creek Home, Llc

Inspection Information - Office: Indiana Department Of Labor

 

Inspection Nr: 307425793
Report ID: 0551800
Date Opened: 07/28/2004

Site Address:
The Fall Creek Home, Llc
53850 Fall Creek Way
Elkhart, IN 46514

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:2452

NAICS: 321992/Prefabricated Wood Building Manufacturing

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 08/20/2004

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 05/11/2005

Related Activity
Type Activity Nr Safety Health
Accident 362665382
Violation Summary
Violations/Penalties Serious Willful Repeat Other Unclass Total
Initial Violations 2 1 3
Current Violations 1 2 3
Initial Penalty $3,500 $0 $0 $0 $0 $3,500
Current Penalty $1,315 $0 $0 $0 $0 $1,315
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 2200080101 09/28/2004 10/25/2004 $0 $1,750 $0 I - Informal Settlement  
2. 01002 Serious 19100178 O01 09/28/2004 10/01/2004 $1,315 $1,750 $0 I - Informal Settlement  
3. 02001 Other 19100178 L06 09/28/2004 10/01/2004 $0 $0 $0 -  

Investigation Summary

Investigation Nr: 200994564
Event: 07/27/2004
Employee is killed when struck by roll of linoleum

On July 27, 2004, Employee #1 and a coworker were installing a rolled section of linoleum (approximately 15 ft, 6 in. long and weighing 800 to 1,000 lbs) into a modular home. The coworker used a Toyota Fork Truck (Model Number 02-5F630) with a lifting device to raise the linoleum. The lifting device was comprised of a rod that projected out approximately 8 ft 6 in. While the material was being lifted and the fork truck was moved, the material fell off the lifting device and struck Employee #1's head and right shoulder. This fractured his neck and killed him.

Keywords: UNSECURED, CONSTRUCTION, INDUSTRIAL TRUCK, STRUCK BY, FALLING OBJECT, UNSTABLE LOAD

Investigated Inspection
# Inspection Age Sex Degree of Injury Nature of Injury Occupation
1 307425793 Fatality Other Laborers, except construction
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