Inspection Detail

Case Status: CLOSED

Inspection: 902534.015 - Woodman'S Food Market, Inc.

Inspection Information - Office: Madison Area Office

Inspection Nr: 902534.015

Report ID: 0523300

Date Opened: 04/24/2013

Site Address:
Woodman'S Food Market, Inc.
1877 Madison Road
Beloit, WI 53511

Mailing Address:
2631 Liberty Lane, Janesville, WI 53545

Union Status: NonUnion

SIC:

NAICS: 445110/Supermarkets and Other Grocery (except Convenience) Stores

Inspection Type: Fat/Cat

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 04/25/2013

Emphasis: L:Fall

Case Closed: 12/13/2013

Related Activity
Type	Activity Nr	Safety	Health
Accident	814963

Case Status: CLOSED

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	2					2
Current Violations	1			1		2
Initial Penalty	$10,000	$0	$0	$0	$0	$10,000
Current Penalty	$4,250	$0	$0	$1,750	$0	$6,000
FTA Penalty	$0	$0	$0	$0	$0	$0

Violation Items
#	Citation ID	Citation Type	Standard Cited	Issuance Date	Abatement Due Date	Current Penalty	Initial Penalty	FTA Penalty	Contest	Latest Event	Note
1.	01001	Serious	19100132 A	09/13/2013	09/23/2013	$4,250	$7,000	$0	10/04/2013	F - Formal Settlement
2.	01002	Other	19100303 G01	09/13/2013	09/23/2013	$1,750	$3,000	$0	10/04/2013	F - Formal Settlement

Investigation Summary

Investigation Nr: 43845.015

Event: 04/20/2013

Employee falls 9 feet from order picker, later dies

At 11:45 on April 20, 2013, Employee #1 was working in a grocery store distribution center, operating an Order Picker, Crown Lift, 3200 Series, Truck Type E, and Serial No. 1A271198, picking orders off of storage shelves Employee #1 was wearing a harness, but was not tied off. The employee went to aisle 60 & 61 to pick a case of peanut butter off of the third shelf. As he tried to grab the case of peanut butter, he tripped and fell nine feet to the concrete floor below. Employee #1 suffered head trauma and was transported to a local hospital where he died three days later when he was removed from life support.

Keywords: Concrete Slab, Fall, Material Handling, PPE, Powered Industrial Vehicle, Storage Area, Struck Against, Tripped, Warehouse

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	902534.015	22	M	Fatality		Industrial truck and tractor equipment operators

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