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Inspection Detail

Inspection: 312687890 - Ds Waters Of America,Inc.Dba Alhambra Sierra Sprin

Inspection Information - Office: San Francisco District Office

 

Inspection Nr: 312687890
Report ID: 0950611
Date Opened: 10/23/2009

Site Address:
Ds Waters Of America,Inc.Dba Alhambra Sierra Sprin
2217 Revere Avenue
San Francisco, CA 94124

Mailing Address:
485 Vista Way, Milpitas, CA 95035

Union Status: Union

SIC:5149

NAICS: 312112/Bottled Water Manufacturing


Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 12/23/2009

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 09/08/2010


Related Activity
Type Activity Nr Safety Health
Accident 101186468
Accident 362196842
Violation Summary
Violations/Penalties Serious Willful Repeat Other Unclass Total
Initial Violations 3 3
Current Violations 3 3
Initial Penalty $0 $0 $0 $860 $0 $860
Current Penalty $0 $0 $0 $860 $0 $860
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 3328 G 01/04/2010 01/07/2010 $335 $335 $0 -  
2. 01002 Other 3663 G 01/04/2010 02/06/2010 $225 $225 $0 -  
3. 01003 Other 3650 T17 01/04/2010 02/06/2010 $300 $300 $0 -  

Investigation Summary

Investigation Nr: 201185055
Event: 10/14/2009
Employee Is Injured in Forklift Accident

On October 14, 2009, an employee was working as an Inter Branch Driver, transporting bottled water from the manufacturing plant, to two distribution facilities in San Francisco and Salinas. He had been working for this employer since 1976. He was responsible loading and unloading his truck using any available forklift at the location. At approximately 4:30 p.m., the employee was operating a Clarks forklift Model Number CGC20, LP, Serial Number C36LI-0214-9510FB; Capacity: 3650 lbs, loading an 18-wheeler truck, 8074 Sterling with Hackney carriage; License Plate Number 9B21600. The load was a 4-tier plastic rack, 4-ft wide by 4.5-ft high, holding 32 empty 5-gallon plastic water bottles. He noted that an empty bottle fell off the rack. He stopped the forklift and dismounted it. As he was retrieving the bottle he realized that the forklift started moving. He jumped back on the forklift from its right side and somehow pressed the gas pedal. The gas pedal got stuck in full throttle and threw him off of the forklift. He was struck against the truck and landed on the ground. The forklift was stopped when it hit the back of the truck while its engine was still running. The employee was transported to SFGH by paramedics. He was transferred to Kaiser Hospital in Hayward on October 18, 2009 and hospitalized for additional 4 days. He suffered multiple pelvic and ribs fractures. The cause of the accident was failure to ensure the forklift's emergency brake was fully engaged before dismounting.

Keywords: FRACTURE, INDUSTRIAL TRUCK, PELVIS, RIB, BRACE, STRUCK BY

Investigated Inspection
# Inspection Age Sex Degree of Injury Nature of Injury Occupation
1 312687890 Hospitalized injury Fracture Truck drivers, heavy
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