Inspection Detail

Inspection: 119634087 - Nicholas Roofing

Inspection Information - Office: American Canyon District Office

Inspection Nr: 119634087

Report ID: 0950615

Date Opened: 11/02/2004

Site Address:
Nicholas Roofing
18 Edgewood Avenue
Mill Valley, CA 94941

Mailing Address:
1816 San Pablo Avenue, Berkeley, CA 94702

Union Status: NonUnion

SIC:1761

NAICS: 238160/Roofing Contractors

Inspection Type: Accident

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 11/10/2004

Planning Guide: Safety-Construction

Emphasis: S:Construction (Cship)

Case Closed: 04/24/2006

Related Activity
Type	Activity Nr	Safety	Health
Accident	361601453

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			1		2
Current Violations	1			1		2
Initial Penalty	$10,800	$0	$0	$100	$0	$10,900
Current Penalty	$0	$0	$0	$100	$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	Other	1675 I	11/15/2004	11/18/2004	$100	$100	$0		-
2.	02001	Serious	1675 J	11/15/2004	11/18/2004	$0	$10,800	$0	11/30/2004	F - Formal Settlement

Investigation Summary

Investigation Nr: 170765069

Event: 11/01/2004

Employee slips and falls from roof

At approximately 12 p.m. on November 1, 2004, Employee #1, working for Nicholas Roofing in Mill Valley, CA, was placing felt underlay for the first course of roofing shingles at the eaves of a newly constructed wing addition of a house. Having placed some felt, Employee #1 moved his ladder, a 20-in. cuprum aluminum extension ladder, leaned it against the eave of the roof and climbed up. As Employee #1 stepped onto the roof he slipped, causing him to fall 12 ft and hit a mounted downspout inlet on the way down. Employee #1 suffered fractured vertebrae. He was an apprentice roofer and was employed 2 months prior to the accident.

Keywords: FRACTURE, ROOF, LADDER, FALL, VERTEBRA

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	119634087			Hospitalized injury	Fracture	Roofers

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