Inspection Detail
Inspection: 307519710 - Primary Structures, Inc. Of Clearwater
Inspection Information - Office: Tampa Area Office
Site Address:
Primary Structures, Inc. Of Clearwater
1200 Gulf Blvd
Treasure Island, FL 33706
Mailing Address:
13131 56th Court Suite 301, Clearwater, FL 33760
Union Status: NonUnion
SIC:1771
NAICS: 238140/Masonry Contractors
Inspection Type: Accident
Scope: Complete
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 05/11/2004
Planning Guide: Safety-Construction
Emphasis: L:Fall, S:Construction Fatalities
Case Closed: 02/01/2005
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 102408721 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 3 | 3 | 1 | 7 | ||
| Current Violations | 3 | 3 | 6 | |||
| Initial Penalty | $8,000 | $0 | $30,400 | $0 | $0 | $38,400 |
| Current Penalty | $4,750 | $0 | $22,050 | $0 | $0 | $26,800 |
| FTA Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| # | Citation ID | Citaton Type | Standard Cited | Issuance Date | Abatement Due Date | Current Penalty | Initial Penalty | FTA Penalty | Contest | Latest Event | Note |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | 01001A | Serious | 19260501 B05 | 08/03/2004 | 08/06/2004 | $2,500 | $4,000 | $0 | 08/17/2004 | F - Formal Settlement | |
| 2. | 01001B | Serious | 19260451 G01 | 08/03/2004 | 08/06/2004 | $0 | $0 | $0 | 08/17/2004 | F - Formal Settlement | |
| 3. | 01002 | Serious | 19260502 D16 III | 08/03/2004 | 08/06/2004 | $1,125 | $2,000 | $0 | 08/17/2004 | F - Formal Settlement | |
| 4. | 01003A | Serious | 19260502 D05 | 08/03/2004 | 08/06/2004 | $1,125 | $2,000 | $0 | 08/17/2004 | F - Formal Settlement | |
| 5. | 01003B | Serious | 19260502 D21 | 08/03/2004 | 08/06/2004 | $0 | $0 | $0 | 08/17/2004 | F - Formal Settlement | |
| 6. | 02001 | Repeat | 19260501 B01 | 08/03/2004 | 08/06/2004 | $9,025 | $11,200 | $0 | 08/17/2004 | F - Formal Settlement | |
| 7. | 02002 | Repeat | 19260503 A01 | 08/03/2004 | 09/05/2004 | $9,025 | $11,200 | $0 | 08/17/2004 | F - Formal Settlement | |
| 8. | 02003 | Repeat | 19260701 B | 08/03/2004 | 08/06/2004 | $4,000 | $8,000 | $0 | 08/17/2004 | F - Formal Settlement | |
| 9. | 03001 | Other | 19260405 A02 III | 08/03/2004 | 08/09/2004 | $0 | $0 | $0 | 08/17/2004 | F - Formal Settlement | Citation has been deleted. |
Investigation Summary
On March 29, 2004, Employee #1 was removing concrete pouring forms at the edge of the third floor of a building undergoing construction. He had removed the guard railing and was using a 2-in by 4-ft wooden board to push the form off the post tension cables. The concrete pouring form was approximately 16-ft long. After removing one side of the wall, he attempted to dislodge the other side with the wooden board. But, as he struck the form using the board, he lost his balance and stepped upon greasy cables causing him to fall. He was killed when he struck the ground approximately 30-ft below.
Keywords: CONCRETE FORM WORK, GUARDRAIL, BUILDING, CONSTRUCTION, FALL, FALL PROTECTION, LOST BALANCE, WORK PLATFORM
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 307519710 | Fatality | Fracture | Construction laborers |
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