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Inspection Detail
Inspection: 315363531 - Mid Peninsula Roofing, Inc.
Inspection Information - Office: Fremont District Office
Site Address:
Mid Peninsula Roofing, Inc.
200 Forrester Road
Los Gatos, CA 95032
Mailing Address:
1326 Marsten Rd., Burlingame, CA 94010
Union Status: NonUnion
SIC:1761
NAICS: 238160/Roofing Contractors
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 08/29/2011
Emphasis: S:Construction (Cship)
Case Closed: 03/10/2012
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 102767084 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 2 | 4 | |||
| Current Violations | 2 | 2 | 4 | |||
| Initial Penalty | $7,420 | $0 | $0 | $620 | $0 | $8,040 |
| Current Penalty | $2,720 | $0 | $0 | $300 | $0 | $3,020 |
| FTA Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| # | Citation ID | Citaton Type | Standard Cited | Issuance Date | Abatement Due Date | Current Penalty | Initial Penalty | FTA Penalty | Contest | Latest Event | Note |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | 01001 | Other | 1509 A | 09/01/2011 | 09/06/2011 | $150 | $310 | $0 | I - Informal Settlement | ||
| 2. | 01002 | Other | 3381 A | 09/01/2011 | 09/06/2011 | $150 | $310 | $0 | I - Informal Settlement | ||
| 3. | 02001 | Serious | 1644 A06 | 09/01/2011 | 09/06/2011 | $2,475 | $3,710 | $0 | I - Informal Settlement | ||
| 4. | 03001 | Serious | 1644 A07 | 09/01/2011 | 09/06/2011 | $245 | $3,710 | $0 | I - Informal Settlement |
Investigation Summary
At approximately 11:10 a.m. on May 24, 2011, Employee #1, a roofer, was walking on the wooden planks of a three tier metal scaffold. As he traveled upon the scaffolding, he tripped or slipped and fell under the mid railing. He attempted to break his fall by grabbing the railing and trees, but fell approximately 25 ft onto compact dirt. Employee #1 sustained a fractured right toe and an unspecified back injury. He was transported to a medical center, where he underwent treatment and was then hospitalized.
Keywords: FRACTURE, SLIP, BACK, TRIPPED, FALL, TOE, SCAFFOLD, SCAFFOLDING
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 315363531 | Hospitalized injury | Fracture | Roofers |