Inspection Detail
Inspection: 312668635 - Potter Roemer Llc
Inspection Information - Office: Monrovia District Office
Site Address:
Potter Roemer Llc
17451 Hurley St
City Of Industry, CA 91744
Mailing Address:
, , 00000
Union Status: NonUnion
SIC:3499
NAICS: 332999/All Other Miscellaneous Fabricated Metal Product Manufacturing
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 03/08/2012
Planning Guide: Safety-Manufacturing
Emphasis:
Case Closed: 03/08/2012
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 102713245 |
Investigation Summary
At approximately 3:40 p.m. on September 7, 2011, Employee #1, with Potter Roemer, LLC, was operating a forklift (Hyster Model Number E50Z-27, Serial Number G108V01605B) onto a truck's trailer to load goods. When the truck pulled away from the loading dock, the forklift fell 4 ft to the ground. Employee #1 jumped from the forklift as it was falling. He sustained sprains, contusions, lacerations, and a concussion.
Keywords: LOADING, INDUSTRIAL TRUCK, LACERATION, TRUCK, FALL, CONCUSSION, TRAILER, LOADING DOCK, SPRAIN
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 312668635 | Non Hospitalized injury | Concussion | Occupation not reported |
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