Inspection Detail

Inspection: 307452904 - Staples Distribution Center

Inspection Information - Office: San Bernardino District Office

Inspection Nr: 307452904

Report ID: 0950633

Date Opened: 05/06/2004

Site Address:
Staples Distribution Center
450 S Cactus Ave
Rialto, CA 92376

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:4225

NAICS: 493110/General Warehousing and Storage

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 07/23/2004

Emphasis:

Case Closed: 07/13/2008

Related Activity
Type	Activity Nr	Safety	Health
Accident	101155901

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				2		2
Current Violations				1		1
Initial Penalty	$0	$0	$0	$5,750	$0	$5,750
Current Penalty	$0	$0	$0	$300	$0	$300
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	09/14/2004	09/17/2004	$0	$5,000	$0	10/15/2004	W - Empr Withdrew	Citation has been deleted.
2.	01002	Other	3650 S05	09/14/2004	09/17/2004	$300	$750	$0	10/15/2004	W - Empr Withdrew

Investigation Summary

Investigation Nr: 201159126

Event: 04/28/2004

Employee Fractures Leg While Operating Pallet Jack

At approximately 3:00 a.m. on April 28, 2004, Employee #1 was operating a Raymond motorized walking-pallet jack, Model Number 112M-FRE80L, in a warehouse to carry office supplies and products that are distributed by his employer. As Employee #1 was maneuvering the jack to turn into an isle, he misjudged the width of the isle and pinned his right leg between the pallet jack and a steel shelving rack. Employee #1 was hospitalized and treated for a fractured right leg, which required orthopedic reconstruction of his right leg. There were witnesses to the accident.

Keywords: FRACTURE, PALLETIZED CARGO, WAREHOUSE, METAL SHEET, CAUGHT BETWEEN, PALLET, STORAGE RACK, JACK, METAL PIPE, LEG

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	307452904			Hospitalized injury	Fracture	Industrial truck and tractor equipment operators

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