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Inspection Detail
Inspection: 902534.015 - Woodman'S Food Market, Inc.
Inspection Information - Office: Madison Area Office
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
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 814963 |
| 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 |
| # | Citation ID | Citaton 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
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
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 902534.015 | 22 | M | Fatality | Industrial truck and tractor equipment operators |