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Inspection Detail
Inspection: 948960.015 - Capform, Inc.
Inspection Information - Office: Dallas Area Office
Site Address:
Capform, Inc.
3521 N. Plano Road
Richardson, TX 75082
Mailing Address:
1455 Halsey Way, Carrollton, TX 75007
Union Status: NonUnion
SIC:
NAICS: 238110/Poured Concrete Foundation and Structure Contractors
Inspection Type: Fat/Cat
Scope: Complete
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 11/18/2013
Emphasis: L:Constr6
Case Closed: 04/07/2014
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 862451 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $7,000 | $0 | $0 | $0 | $0 | $7,000 |
| Current Penalty | $5,000 | $0 | $0 | $0 | $0 | $5,000 |
| 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. | 01001A | Serious | 19260501 B04 I | 03/12/2014 | 03/20/2014 | $0 | $7,000 | $0 | I - Informal Settlement | Citation has been deleted. | |
| 2. | 01001B | Serious | 19260502 I03 | 03/12/2014 | 03/20/2014 | $5,000 | $0 | $0 | I - Informal Settlement |
Investigation Summary
At approximately 12:30 p.m. on November 18, 2013, Employee #1 was working on the fourth level of a commercial building under construction. He was arranging aluma-form materials. As he was working, he fell through a uncovered floor hole, falling approximately 24.7 ft and striking the next floor level. Employee #1 suffered head trauma and was transported to a local hospital, but died en-route to the hospital.
Keywords: Fall, Floor Opening
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 948960.015 | 41 | M | Fatality | Concrete and terrazzo finishers |