Inspection Detail

Inspection: 315548370 - Sysco Guest Supply, Llc

Inspection Information - Office: Nc Department Of Labor - Charlotte

Inspection Nr: 315548370

Report ID: 0453730

Date Opened: 03/28/2011

Site Address:
Sysco Guest Supply, Llc
202 Ramdin Ct Nw
Concord, NC 28027

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:5087

NAICS: 423850/Service Establishment Equipment and Supplies Merchant Wholesalers

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Health

Close Conference: 06/08/2011

Planning Guide: Health-Manufacturing

Emphasis:

Case Closed: 06/25/2013

Related Activity
Type	Activity Nr	Safety	Health
Accident	102099827

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	4					4
Current Violations	1			2		3
Initial Penalty	$12,550	$0	$0	$0	$0	$12,550
Current Penalty	$8,000	$0	$0	$0	$0	$8,000
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	95012901	06/10/2011	06/20/2011	$8,000	$3,500	$0	08/03/2011	J - ALJ Decision
2.	01002	Serious	19100132 A	06/10/2011	06/20/2011	$4,500	$4,500	$0	08/03/2011	J - ALJ Decision	Citation has been deleted.
3.	01003	Other	19100178 L04 III	06/10/2011	06/15/2011	$0	$3,500	$0	08/03/2011	J - ALJ Decision
4.	01004	Other	19100178 M05 I	06/10/2011	06/20/2011	$0	$1,050	$0	08/03/2011	J - ALJ Decision

Investigation Summary

Investigation Nr: 202080842

Event: 03/28/2011

Employee Falls from Elevation and Is Killed

On March 28, 2011, Employee #1 was standing on the forks of a powered industrial truck, which were raised 19 ft to the top of a storage rack. As he stood on the top of the storage rack, he attempted to straighten a leaning pallet of boxes. The boxes fell and knocked him off the rack. He struck the concrete floor below and died.

Keywords: FALL, STORAGE RACK, STRUCK BY, ELEVATED WORK PLAT, FALLING OBJECT

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	315548370			Fatality	Other	Supervisors, material moving equipment operators

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