Inspection Detail

Inspection: 125711754 - Mike Jackson Construction

Inspection Information - Office: Sacramento District Office

Inspection Nr: 125711754

Report ID: 0950621

Date Opened: 11/29/2004

Site Address:
Mike Jackson Construction
6th & South Sts
Orland, CA 95963

Mailing Address:
4483 County Rd Mm, Orland, CA 95963

Union Status: NonUnion

SIC:1794

NAICS: 238910/Site Preparation Contractors

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 04/13/2005

Planning Guide: Safety-Construction

Emphasis: S:Construction (Cship)

Case Closed: 04/21/2006

Related Activity
Type	Activity Nr	Safety	Health
Accident	101171254

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				2		2
Current Violations				2		2
Initial Penalty	$0	$0	$0	$785	$0	$785
Current Penalty	$0	$0	$0	$785	$0	$785
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	3410001 F03	05/13/2005	05/18/2005	$435	$435	$0		-
2.	01002	Other	1541 E	05/13/2005	05/18/2005	$350	$350	$0		-

Investigation Summary

Investigation Nr: 201176880

Event: 11/18/2004

Employee Is Injured When Struck by Piece of Concrete

On November 18, 2004, Employee #1, a laborer, was involved in excavating work. He moved a dump truck to a position, so the backhoe operator could load spoils from the excavation into the dump truck. Employee #1 was walking to the back of the truck as the backhoe operator loaded the dump truck bed. A piece of concrete came out of the truck bed and struck Employee #1 on his hard hat. Employee #1 was knocked to the ground but was not seriously injured.

Keywords: LOADING, EXCAVATION, HEAD, HARD HAT, CONSTRUCTION, LACERATION, DUMP TRUCK, STRUCK BY, BACKHOE, CONCRETE

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	125711754			Non Hospitalized injury	Cut/Laceration	Construction laborers

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