Inspection Detail

Inspection: 125710053 - Formline Solid Surfacing, Inc.

Inspection Information - Office: Sacramento District Office

Inspection Nr: 125710053

Report ID: 0950621

Date Opened: 01/14/2003

Site Address:
Formline Solid Surfacing, Inc.
1247 Blumenfeld Dr.
Sacramento, CA 95815

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:1799

NAICS: 531312/Nonresidential Property Managers

Inspection Type: Accident

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 01/14/2003

Emphasis:

Case Closed: 09/19/2006

Related Activity
Type	Activity Nr	Safety	Health
Accident	361729551

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			2		3
Current Violations	1			2		3
Initial Penalty	$2,700	$0	$0	$150	$0	$2,850
Current Penalty	$2,700	$0	$0	$150	$0	$2,850
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	Latest Event
1.	01001	Other	342 A	03/18/2003	03/21/2003	$100	$100	$0	-
2.	01002	Other	3203 A	03/18/2003	03/28/2003	$50	$50	$0	-
3.	02001	Serious	4302 E	03/18/2003	04/04/2003	$2,700	$2,700	$0	-

Investigation Summary

Investigation Nr: 201172681

Event: 03/05/2002

Employee injured while operating table saw

At approximately 2:30 p.m. on March 5, 2002, Employee #1, a shop fabrication foreman employed by Formline Solid Surfacing, Inc., was operating a 10-foot table saw cutting pieces of Corian counter top material. The material became jammed and, while clearing the jam, the material moved and the victims hand struck the saw blade. The saw was unguarded. First aid was provided at the site by emergency services. The employee was transported to UCD Medical Center in Sacramento, and then transported by air to California Pacific Hospital in San Francisco, where three fingers on his left hand were reattached.

Keywords: FINGER, STRUCK AGAINST, JAMMED, SAW, UNGUARDED, TABLE SAW

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	125710053			Hospitalized injury	Amputation	Sawing machine operators

Thank You for Visiting Our Website

You are exiting the Department of Labor's Web server.

The Department of Labor does not endorse, takes no responsibility for, and exercises no control over the linked organization or its views, or contents, nor does it vouch for the accuracy or accessibility of the information contained on the destination server. The Department of Labor also cannot authorize the use of copyrighted materials contained in linked Web sites. Users must request such authorization from the sponsor of the linked Web site. Thank you for visiting our site. Please click the button below to continue.