Inspection Detail

Inspection: 300863230 - National R V

Inspection Information - Office: San Bernardino District Office

Inspection Nr: 300863230

Report ID: 0950633

Date Opened: 08/20/2003

Site Address:
National R V
100 W Sinclair Street
Perris, CA 92571

Mailing Address:
3411 N Perris Blvd, Perris, CA 92571

Union Status: NonUnion

SIC:5012

NAICS: 423110/Automobile and Other Motor Vehicle Merchant Wholesalers

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 01/02/2004

Emphasis:

Case Closed: 01/22/2004

Related Activity
Type	Activity Nr	Safety	Health
Accident	362459612

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				2		2
Current Violations				2		2
Initial Penalty	$0	$0	$0	$800	$0	$800
Current Penalty	$0	$0	$0	$800	$0	$800
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	3622 F07	01/02/2004	01/16/2004	$400	$400	$0		-
2.	01002	Other	3203 A02	01/02/2004	01/16/2004	$400	$400	$0		-

Investigation Summary

Investigation Nr: 201157831

Event: 07/25/2003

Employee Injures Legs When Struck By Falling Scaffold

At approximately 9:45 a.m. on July 25, 2003, Employee #1 was moving a mobile scaffold that was 31.5-feet long, 32-inches wide, and 6 feet, 5 inches high. He was working by himself and moving the scaffold from Bay Number 4 to Bay Number 8 in front of the service area. The asphalt floor was slightly sloped. Employee #1 started pushing the scaffold from the rear end. He was not able control the scaffold by pushing it, so he decided to pull from the front end of the scaffold. As he was pulling from the front end, the rear end of the scaffold swung to the low side of the floor and hit the concrete pavement near the ventilation system. Due to the impact, the scaffold tipped over and fell on both of his legs. The guardrails of the scaffold struck him on the head before it fell. Employee #1 sustained multiple fractures to both of his legs, which required hospitalization for seven days.

Keywords: FRACTURE, GUARDRAIL, MOBILE SCAFFOLD, WORK RULES, STRUCK BY, FALLING OBJECT, LOST CONTROL, SLOPE, LEG

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	300863230			Hospitalized injury	Fracture	Technicians, n.e.c.

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