Inspection Detail

Inspection: 126107549 - Contractor'S Warehouse

Inspection Information - Office: Monrovia District Office

Inspection Nr: 126107549

Report ID: 0950644

Date Opened: 07/28/2004

Site Address:
Contractor'S Warehouse
1680 W. Mission Blvd.
Pomona, CA 91766

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:5211

NAICS: 444110/Home Centers

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 10/29/2004

Emphasis:

Case Closed: 09/16/2006

Related Activity
Type	Activity Nr	Safety	Health
Accident	362595548

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			1		2
Current Violations	1			1		2
Initial Penalty	$6,750	$0	$0	$375	$0	$7,125
Current Penalty	$2,700	$0	$0	$0	$0	$2,700
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	3660 A	10/29/2004	12/01/2004	$0	$375	$0		I - Informal Settlement
2.	02001	Serious	3650 S12	10/29/2004	12/01/2004	$2,700	$6,750	$0		I - Informal Settlement

Investigation Summary

Investigation Nr: 201798725

Event: 06/28/2004

Employee Is Injured When Run over by Forklift

At about 7:25 p.m. on June 28, 2004, Employee #1 was working in the lumber yard of a building material retail store, writing customer tickets customer and straightening units of plywood sheet loaded in a forklift against a metal pole. The forklift operator backed up and run over Employee #1's right ankle, causing him to fall and twist his left ankle. He was taken treated at a hospital for a right foot contusion and a left ankle strain.

Keywords: INDUSTRIAL TRUCK, LUMBER, RUN OVER, STORAGE AREA, ANKLE, CONTUSION

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	126107549			Non Hospitalized injury	Bruise/Contus/Abras	Industrial truck and tractor equipment operators

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