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Inspection Detail

Inspection: 301136578 - Mervyn'S N. D. C.

Inspection Information - Office: Oakland District Office

 

Inspection Nr: 301136578
Report ID: 0950614
Date Opened: 06/04/2003

Site Address:
Mervyn'S N. D. C.
48200 Fremont Blvd.
Fremont, CA 94538

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:5411

NAICS: 452910/Warehouse Clubs and Supercenters

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 09/19/2003

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 06/26/2006

Related Activity
Type Activity Nr Safety Health
Accident 361487283
Violation Summary
Violations/Penalties Serious Willful Repeat Other Unclass Total
Initial Violations 4 1 5
Current Violations 4 1 5
Initial Penalty $14,400 $0 $0 $200 $0 $14,600
Current Penalty $3,300 $0 $0 $200 $0 $3,500
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 6151 C01 09/22/2003 10/02/2003 $200 $200 $0 10/09/2003 F - Formal Settlement  
2. 02001 Serious 5162 C 09/22/2003 10/02/2003 $0 $3,600 $0 10/09/2003 F - Formal Settlement  
3. 03001 Serious 4650 D 09/22/2003 10/02/2003 $2,700 $3,600 $0 10/09/2003 F - Formal Settlement  
4. 04001 Serious 4002 A 09/22/2003 10/02/2003 $300 $3,600 $0 10/09/2003 F - Formal Settlement  
5. 05001 Serious 3314 F 09/22/2003 10/02/2003 $300 $3,600 $0 10/09/2003 F - Formal Settlement  

Investigation Summary

Investigation Nr: 201503836
Event: 05/14/2003
Employee injured in fall on conveyor belt

On May 14, 2005, Employee #1 was walking over a conveyor belt to dislodge material which had jammed. He lost his footing and fell, catching his left hand between the belt and a steel roller, scraping off skin and contusing the hand. Employee #1 was taken to Washington Hospital in Fremont, California, where he underwent skin grafting. Employee #1 is a diabetic and has experienced very slow healing of the injury. The injury may result in permanent disability.

Keywords: JAMMED, ROLLER--MACH/PART, FALL, CONVEYOR BELT, HAND, CONTUSION

Investigated Inspection
# Inspection Age Sex Degree of Injury Nature of Injury Occupation
1 301136578 Hospitalized injury Bruise/Contus/Abras Occupation not reported
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