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Inspection Detail
Inspection: 951111.015 - Black Signet Llc
Inspection Information - Office: Englewood Area Office
Site Address:
Black Signet Llc
114 Capricio Circle
Pagosa Springs, CO 81147
Mailing Address:
565 Cloud Cap Ave., Pagosa Springs, CO 81147
Union Status: NonUnion
SIC:
NAICS: 238320/Painting and Wall Covering Contractors
Inspection Type: Fat/Cat
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 10/30/2013
Emphasis:
Case Closed: 12/03/2013
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 858976 | Yes | |
| Inspection | 945822 | Yes |
Investigation Summary
At approximately 3:45 p.m. on October 28, 2013, Employee #1 was working from a 10 ft extension ladder and spraying product onto the siding of a house that he brushed to coat the siding. The ladder was placed on top of a 2 tiered, 12 ft high mobile scaffold. While he was spraying the product, the scaffold rolled away from the wall and the ladder slid down the wall leaving scrape marks on the wall. Then the scaffold fell such that the top fell away from the wall of the house and the ladder and the Employee #1 fell down to the driveway. He landed on the top of his head fracturing his skull and neck and died.
Keywords: Elevated Work Platform, Fall, Ladder, Residential Construction, Scaffold
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 951111.015 | 52 | M | Fatality | Painters, construction and maintenance |