Inspection Detail

Inspection: 18345488 - Duffee-Forms, Inc.

Inspection Information - Office: Atlanta East Area Office

Inspection Nr: 18345488

Report ID: 0418100

Date Opened: 01/04/1990

Site Address:
Duffee-Forms, Inc.
9750 Spruill Road
Alpharetta, GA 30201

Mailing Address:
2627 N. Emerson Ave., Indianapolis, IN 46218

Union Status: NonUnion

SIC:1771

NAICS: 0

Inspection Type: Unprog Rel

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 01/12/1990

Planning Guide: Safety-Construction

Emphasis:

Case Closed: 09/27/1991

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	5					5
Current Violations	5					5
Initial Penalty	$1,680	$0	$0	$0	$0	$1,680
Current Penalty	$1,680	$0	$0	$0	$0	$1,680
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
1.	01001	Serious	19260021 B02	01/23/1990	01/26/1990	$420	$420	$0	03/21/1990	-
2.	01002	Serious	19260404 B01 II	01/23/1990	02/12/1990	$280	$280	$0	03/21/1990	-
3.	01003	Serious	19260405 A02 IIJ	01/23/1990	01/26/1990	$210	$210	$0	03/21/1990	-
4.	01004A	Serious	19260500 D01	01/23/1990	01/26/1990	$350	$350	$0	03/21/1990	-
5.	01004B	Serious	19260500 D02	01/23/1990	01/26/1990	$0	$0	$0	03/21/1990	-
6.	01005	Serious	19260550 A04	01/23/1990	01/26/1990	$420	$420	$0	03/21/1990	-

Investigation Summary

Investigation Nr: 14336903

Event: 01/04/1990

EMPLOYEE INJURED BY MOVING FORM

Employee #1 was sitting on a gang form that was leaning against a cement wall. The form slipped and Employee #1 struck his face on the cross bracing of the form as the form hit the floor. Employee #1 sustained lacerations and several teeth were knocked out.

Keywords: WALL, STRUCK AGAINST, LACERATION, FACE

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	18345488			Hospitalized injury	Bruise/Contus/Abras	Occupation not reported

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