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Inspection Detail
Inspection: 111265989 - Cook Forms
Inspection Information - Office: Dosh Spokane Service Location, Spokane, Wa
Site Address:
Cook Forms
Top Of Lookout Mtn Ln Off Hazard Rd
Spokane, WA 99208
Mailing Address:
3621 N Molter, Otis Orchards, WA 99027
Union Status: NonUnion
SIC:1771
NAICS: 0
Inspection Type: Accident
Scope: Complete
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 08/09/1994
Emphasis: L:Constr
Case Closed: 12/19/1994
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 361226871 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $0 | $0 | $80 | $0 | $0 | $80 |
| Current Penalty | $0 | $0 | $80 | $0 | $0 | $80 |
| 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 | Repeat | 1550011007 | 09/09/1994 | 10/12/1994 | $80 | $80 | $0 | 10/10/1994 | Y - State Decision |
Investigation Summary
Employees #1 and #2 were crushed by an 8 ft by 56 ft concrete-filled residential concrete form assembly for an 8 in. wall. The wall toppled and pinned them to the bottom of the excavation. They had to be dug out. Both employees were hospitalized with multiple injuries including fractured pelvises.
Keywords: CONCRETE FORM WORK, EXCAVATION, FRACTURE, PINNED, WORK RULES, CONSTRUCTION, PELVIS, STRUCK BY, BURIED, FALLING OBJECT
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 111265989 | Hospitalized injury | Fracture | Occupation not reported | ||
| 2 | 111265989 | Hospitalized injury | Fracture | Occupation not reported |