Inspection Detail

Inspection: 307456079 - Dave Canada Distribution Services

Inspection Information - Office: San Bernardino District Office

Inspection Nr: 307456079

Report ID: 0950633

Date Opened: 03/08/2005

Site Address:
Dave Canada Distribution Services
41715 N Enterprise Circle
Temecula, CA 92590

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:5149

NAICS: 424490/Other Grocery and Related Products Merchant Wholesalers

Inspection Type: Accident

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 07/07/2005

Emphasis:

Case Closed: 10/09/2006

Related Activity
Type	Activity Nr	Safety	Health
Accident	102440633

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				2		2
Current Violations				2		2
Initial Penalty	$0	$0	$0	$435	$0	$435
Current Penalty	$0	$0	$0	$435	$0	$435
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	3660 A	07/07/2005	07/12/2005	$85	$85	$0		-
2.	01002	Other	3650 S17	07/07/2005	07/12/2005	$350	$350	$0		-

Investigation Summary

Investigation Nr: 202440608

Event: 03/08/2005

Employee receives injuries when struck by forklift

At approximately 10:05 a.m. on March 8, 2005, Employee #1, a delivery driver, was operating a Caterpillar Type G Fork Lift, Model 499A. He exited from the vehicle to assist a contract worker in turning a pallet of product on a trailer bed. While helping the contract worker, his unattended forklift rolled and struck him from behind. Employee #1 was pinned between the forklift mast and the trailer bumper. The contract worker leaped from the trailer and backed up the forklift. Emergency medical personnel were summoned to the scene of the accident. They administered first aid and transported Employee #1 to a medical center. He was admitted for surgery with a fractured tibia and fibula to his left leg, and was hospitalized for four days.

Keywords: DELIVERY WORK, FRACTURE, VEHICLE IN GEAR, INDUSTRIAL TRUCK, STRUCK BY, LEG, TRUCK DRIVER

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	307456079			Hospitalized injury	Fracture	Truck drivers, light

Thank You for Visiting Our Website

You are exiting the Department of Labor's Web server.

The Department of Labor does not endorse, takes no responsibility for, and exercises no control over the linked organization or its views, or contents, nor does it vouch for the accuracy or accessibility of the information contained on the destination server. The Department of Labor also cannot authorize the use of copyrighted materials contained in linked Web sites. Users must request such authorization from the sponsor of the linked Web site. Thank you for visiting our site. Please click the button below to continue.