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Accident: 170672570 - Employee Killed In Fall From Concrete Forms

Accident: 170672570 -- Report ID: 0452110 -- Event Date: 09/28/1993
InspectionOpen DateSICEstablishment Name
12379569209/30/19931771Kay & Kay Contracting, Inc.
A large culvert was being built for new highway construction. Employee #1 and three coworkers were working at 10 to 12 ft on top of concrete forms without fall protection. Two coworkers were dumping a bucket of concrete while Employee #1 was manipulating a concrete vibrator. The other coworker was doing finishing work. The back form wall was consistently 12 ft high and the inside wall was 12 ft half the distance and then dropped to 10 ft in height. A temporary block measuring 2 ft by 2 ft was used as a leveler between the 12 ft and 10 ft sections of the walls in order to stabilize the concrete chute. According to the coworkers, Employee #1 apparently fell when he either inadvertently backed from the upper level to the lower or slipped on the non-stationary block. Employee #1 died.
Keywords: concrete form work, work rules, construction, vibrator, unstable surface, fall, fall protection, elevated work plat, backing up
Employee # Inspection Age Sex Degree Nature Occupation
1 123795692 Fatality Fracture Supervisors; carpenters and related workers

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