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Inspection Detail
Inspection: 306177668 - United Forming, Inc.
Inspection Information - Office: Fort Lauderdale Area Office
Site Address:
United Forming, Inc.
6000 Island Blvd. Williams Island
Aventura, FL 33160
Mailing Address:
1650 Sand Lake Road, Suite 306, Orlando, FL 32809
Union Status: NonUnion
SIC:1771
NAICS: 238110/Poured Concrete Foundation and Structure Contractors
Inspection Type: Accident
Scope: Complete
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 04/18/2003
Emphasis: S:Construction Fatalities
Case Closed: 09/22/2003
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 100675743 | ||
| Referral | 200682128 | Yes |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 1 | 3 | |||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $14,000 | $0 | $10,000 | $0 | $0 | $24,000 |
| Current Penalty | $7,000 | $0 | $0 | $0 | $0 | $7,000 |
| FTA Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| # | Citation ID | Citaton Type | Standard Cited | Issuance Date | Abatement Due Date | Current Penalty | Initial Penalty | FTA Penalty | Contest | Latest Event | Note |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | 01001 | Serious | 19260020 B01 | 04/18/2003 | 04/26/2003 | $7,000 | $7,000 | $0 | 05/12/2003 | J - ALJ Decision | |
| 2. | 01002 | Serious | 19260703 A01 | 04/18/2003 | 04/24/2003 | $7,000 | $7,000 | $0 | 05/12/2003 | J - ALJ Decision | Citation has been deleted. |
| 3. | 02001 | Repeat | 19261051 A | 04/18/2003 | 04/24/2003 | $10,000 | $10,000 | $0 | 05/12/2003 | J - ALJ Decision | Citation has been deleted. |
Investigation Summary
At approximately 2:30 p.m. on March 17, 2003, Employee #1 and a coworker were installing the bulkhead on a column surrounded by two aluminum forms. One form was secured and anchored to the concrete foundation and the other was not. When Employee #1 climbed the unsecured form, it came loose and he fell. The form landed on top of Employee #1, killing him.
Keywords: CONCRETE FORM WORK, UNSECURED, CONSTRUCTION, FALL, STRUCK BY
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 306177668 | Fatality | Bruise/Contus/Abras | Carpenters |