Inspection Detail

Inspection: 301885216 - Southland Forming, Inc.

Inspection Information - Office: Fort Lauderdale Area Office

Inspection Nr: 301885216

Report ID: 0418800

Date Opened: 05/21/1999

Site Address:
Southland Forming, Inc.
8930 Bay Colony Drive
Naples, FL 34108

Mailing Address:
3939 South Congress Ave. Suite 103, Lake Worth, FL 33461

Union Status: NonUnion

SIC:1771

NAICS: 0

Inspection Type: Accident

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 05/21/1999

Emphasis: S:Construction Fatalities

Case Closed: 09/01/1999

Related Activity
Type	Activity Nr	Safety	Health
Accident	100672203

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	2			1		3
Current Violations	2			1		3
Initial Penalty	$14,000	$0	$0	$1,000	$0	$15,000
Current Penalty	$11,200	$0	$0	$0	$0	$11,200
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	Latest Event
1.	01001A	Serious	19260502 E01	06/30/1999	07/07/1999	$5,600	$7,000	$0	I - Informal Settlement
2.	01001B	Serious	19260502 E02	06/30/1999	07/07/1999	$0	$0	$0	I - Informal Settlement
3.	01002	Serious	19260703 A01	06/30/1999	07/07/1999	$5,600	$7,000	$0	I - Informal Settlement
4.	02001	Other	19040002 A	06/30/1999	07/13/1999	$0	$1,000	$0	I - Informal Settlement

Investigation Summary

Investigation Nr: 200671865

Event: 05/20/1999

Employee killed in fall with concrete column form

Employee #1, a carpenter and laborer, was placing pins at the top of a column form on the 12th floor level. The safety lanyard of his full body harness was looped around the steel rebar sticking up from the top of the form. The form and Employee #1 fell approximately 130 ft to the ground level deck. He was killed.

Keywords: CONCRETE FORM WORK, UNSECURED, WORK RULES, CONSTRUCTION, FALL, FALL PROTECTION, TIE-OFF

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	301885216			Fatality	Bruise/Contus/Abras	Carpenters

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