Inspection Detail

Inspection: 307946327 - Courtesy Corporation - Mcdonalds

Inspection Information - Office: Minnesota Department Of Labor And Industry

Inspection Nr: 307946327

Report ID: 0552700

Date Opened: 01/18/2005

Site Address:
Courtesy Corporation - Mcdonalds
955 High Point Dr Ne
Byron, MN 55920

Mailing Address:
2700 National Dr Suite 100, Onalaska, WI 54650

Union Status: NonUnion

SIC:5812

NAICS: 722211/Limited-Service Restaurants

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 02/01/2005

Emphasis:

Case Closed: 05/04/2005

Related Activity
Type	Activity Nr	Safety	Health
Accident	100510486

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	2					2
Current Violations	2					2
Initial Penalty	$3,150	$0	$0	$0	$0	$3,150
Current Penalty	$3,150	$0	$0	$0	$0	$3,150
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	182065302	04/19/2005	04/29/2005	$1,050	$1,050	$0	-
2.	01002A	Serious	19100026 C03 III	04/19/2005	04/22/2005	$2,100	$2,100	$0	-
3.	01002B	Serious	19100026 C03 IV	04/19/2005	04/22/2005	$0	$0	$0	-

Investigation Summary

Investigation Nr: 200513653

Event: 01/13/2005

Employee Is Killed in Fall from Ladder

On January 13, 2005, Employee #1, of Courtesy Corporation McDonald's, fell from a ladder while replacing letters on the sign in front of the store. He was killed.

Keywords: HEAD, LADDER, FALL

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	307946327			Fatality	Concussion	Janitors and cleaners

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