Inspection Detail

Inspection: 313136301 - Champion Builders

Inspection Information - Office: Madison Area Office

Inspection Nr: 313136301

Report ID: 0523300

Date Opened: 12/01/2010

Site Address:
Champion Builders
R8e Patriot Pass
Fort Mccoy, WI 54656

Mailing Address:
17 W. Willow Street, Chippewa Falls, WI 54729

Union Status: NonUnion

SIC:1761

NAICS: 238160/Roofing Contractors

Inspection Type: Complaint

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 02/25/2011

Emphasis: L:Fall, S:Fall From Height, S:Residential Constr

Case Closed: 02/23/2016

Related Activity
Type	Activity Nr	Safety	Health
Complaint	206862906	Yes

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	2					2
Current Violations	2					2
Initial Penalty	$8,400	$0	$0	$0	$0	$8,400
Current Penalty	$8,400	$0	$0	$0	$0	$8,400
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	Serious	19260502 D21	03/03/2011	03/09/2011	$4,200	$4,200	$0		-
2.	01002	Serious	19260503 A01	03/03/2011	03/15/2011	$4,200	$4,200	$0		-

Investigation Summary

Investigation Nr: 200802585

Event: 09/08/2010

Employee's Back Is Fractured When He Falls from a Roof

On September 8, 2010, Employee #1 was working on a roof removing a plastic roof covering. He slipped on the plastic covering due to wet conditions and fell approximately 10.6 ft. His fall protection system did not activate. The fall protection system was altered with a bolt. Employee #1 was unaware that this fall protection system was altered. Employee #1 was hospitalized with a fractured back.

Keywords: FRACTURE, ROOF, SLIP, EQUIPMENT FAILURE, BACK, ROOFER, FALL PROTECTION, SLIPPERY SURFACE, LOST BALANCE

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	313136301			Hospitalized injury	Fracture	Carpenters

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