Inspection Detail

Inspection: 306426214 - Cbi Structures

Inspection Information - Office: Dosh Seattle Service Location, Seattle, Wa

Inspection Nr: 306426214

Report ID: 1055320

Date Opened: 09/04/2003

Site Address:
Cbi Structures
2424 Sw Andover
Seattle, WA 98104

Mailing Address:
Po Box 82040, Kenmore, WA 98028

Union Status: NonUnion

SIC:1541

NAICS: 236220/Commercial and Institutional Building Construction

Inspection Type: Accident

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 11/14/2003

Emphasis: L:Conhigh

Case Closed: 02/28/2004

Related Activity
Type	Activity Nr	Safety	Health
Accident	101196558

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			1		2
Current Violations	1			1		2
Initial Penalty	$2,200	$0	$0	$0	$0	$2,200
Current Penalty	$2,200	$0	$0	$0	$0	$2,200
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	1550050504 D	01/23/2004	09/04/2003	$2,200	$2,200	$0	-
2.	01001B	Serious	15524510	01/23/2004	09/04/2003	$0	$0	$0	-
3.	01001C	Serious	1552450501	01/23/2004	09/04/2003	$0	$0	$0	-
4.	02001	Other	1552450504 A	01/23/2004	09/04/2003	$0	$0	$0	-

Investigation Summary

Investigation Nr: 202351102

Event: 09/04/2003

Employee is killed after fall from roof

On September 4, 2003, Employee #1 was carrying material to roofers when he slipped and fell backwards, sliding onto skylight that was old, brittle, and uncovered. He broke through the skylight, fell approximately 50 ft onto machinery, and was killed.

Keywords: SKYLIGHT, HEAD, ROOF, WORK RULES, SLIP, LACERATION, FALL

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	306426214			Fatality	Cut/Laceration	Occupation not reported

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