Inspection Detail

Inspection: 307828640 - Sleep Country Usa Inc

Inspection Information - Office: Or-E-Portland - Safety 1 1054111

Inspection Nr: 307828640

Report ID: 1054112

Date Opened: 08/06/2004

Site Address:
Sleep Country Usa Inc
5842 Ne 112th #205
Portland, OR 97220

Mailing Address:
Ct Corporation System 388 State St Ste 420, Salem, OR 97301

Union Status: NonUnion

SIC:5712

NAICS: 442110/Furniture Stores

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 09/23/2004

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 01/24/2005

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			3		4
Current Violations	1			3		4
Initial Penalty	$2,500	$0	$0	$0	$0	$2,500
Current Penalty	$2,500	$0	$0	$0	$0	$2,500
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	Latest Event
1.	01001	Serious	702012501	10/07/2004	10/13/2004	$2,500	$2,500	$0	-
2.	02002	Other	701076506 B A	10/07/2004	11/07/2004	$0	$0	$0	-
3.	02003	Other	701076506 D AI	10/07/2004	11/07/2004	$0	$0	$0	-
4.	02004	Other	701076507 C	10/07/2004	11/07/2004	$0	$0	$0	-

Investigation Summary

Investigation Nr: 201634581

Event: 08/04/2004

Employee is injured in fall from aerial lift

On August 4, 2004, Employee #1 was operating an order picker, a type of aerial lift device, in a warehouse in order to pull stock from the third level of a storage rack system. He fell approximately 16 feet to the concrete floor. He was hospitalized and treated for a concussion.

Keywords: PPE, WAREHOUSE, FALL, FALL PROTECTION, CONCUSSION, WORK PLATFORM, WORK SURFACE, AERIAL LIFT

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	307828640			Hospitalized injury	Concussion	Occupation not reported

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