Translate
Inspection Detail
Inspection: 15003031 - Form Bar Inc
Inspection Information - Office: Nc Department Of Labor - Raleigh
Site Address:
Form Bar Inc
225 Hillsborough St
Raleigh, NC 27601
Mailing Address:
4401 Hopson Dr, Raleigh, NC 27604
Union Status: NonUnion
SIC:1799
NAICS: 0
Inspection Type: Accident
Scope: Complete
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 03/06/1985
Emphasis:
Case Closed: 05/09/1985
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 360611610 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| Current Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| FTA Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| # | Citation ID | Citation Type | Standard Cited | Issuance Date | Abatement Due Date | Current Penalty | Initial Penalty | FTA Penalty | Contest | Latest Event | Note |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | 01001 | Other | 19260402 A11 | 04/15/1985 | 04/18/1985 | $0 | $0 | $0 | - |
Investigation Summary
Employee #1 was working atop a 12 ft tall concrete wall form next to a 10 ft tall excavation wall. The excavation wall collapsed 50 ft south of Employee #1, causing the entire excavation wall to come down in a domino effect. Employee #1 realized what was happening and jumped from the wall form, but he was unable to get away before the collapsing wall knocked over the wall form. He was struck on his lower left side by a 4 by 4 timber that had broken loose from the wall form. He was still under a physician's care when this inspection was concluded.
Keywords: WALL, COLLAPSE, CONSTRUCTION, STRUCK BY, FALLING OBJECT
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 15003031 | Hospitalized injury | Bruise/Contus/Abras | Helpers, construction trades |