Inspection Detail

Inspection: 114614274 - Champion Well Service Inc

Inspection Information - Office: Wyoming Department Of Workforce Services - Osha Division

Inspection Nr: 114614274

Report ID: 0855610

Date Opened: 11/19/1993

Site Address:
Champion Well Service Inc
1/4 Mi S Of Hwy 50 On Bell Rd
Gillette, WY 82716

Mailing Address:
P.O. Box 4222, Gillette, WY 82717

Union Status: NonUnion

SIC:1389

NAICS: 0

Inspection Type: Accident

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 11/19/1993

Planning Guide: Safety-Manufacturing

Emphasis: L:Oilserv

Case Closed: 05/18/1994

Related Activity
Type	Activity Nr	Safety	Health
Accident	362317943

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	2					2
Current Violations	1					1
Initial Penalty	$275	$0	$0	$0	$0	$275
Current Penalty	$100	$0	$0	$0	$0	$100
FTA Penalty	$0	$0	$0	$0	$0	$0

Violation Items
#	Citation ID	Citaton Type	Standard Cited	Issuance Date	Abatement Due Date	Current Penalty	Initial Penalty	FTA Penalty	Contest	Latest Event	Note
1.	01001	Serious	27110105 B06A	04/22/1994	05/20/1994	$0	$175	$0		I - Informal Settlement	Citation has been deleted.
2.	01002	Serious	OS040005 K	04/22/1994	05/20/1994	$100	$100	$0		I - Informal Settlement

Investigation Summary

Investigation Nr: 170705362

Event: 11/18/1993

Employee struck and killed by derrick of falling service rig

While a crew was down rigging a service rig with the derrick telescoped down, the guy lines disconnected and the derrick broke loose from the carrier vehicle in the vicinity of the hinge pins. It rotated 180 degrees before landing on the ground parallel to the carrier vehicle. Employee #1 was pinned under the derrick superstructure. He sustained severe trauma to the upper body and head, and died.

Keywords: CHEST, DERRICK, HEAD, UNSECURED, PINNED, EQUIPMENT FAILURE, GUY, OIL WELL SERVICING, STRUCK BY, FALLING OBJECT

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	114614274			Fatality	Other	Occupation not reported

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