Inspection Detail

Inspection: 306702911 - Carpet Shoppe

Inspection Information - Office: Kansas City Area Office

Inspection Nr: 306702911

Report ID: 0728500

Date Opened: 12/29/2003

Site Address:
Carpet Shoppe
1827 East Seminole
Springfield, MO 65804

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:4225

NAICS: 493110/General Warehousing and Storage

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 01/07/2004

Emphasis:

Case Closed: 05/21/2004

Related Activity
Type	Activity Nr	Safety	Health
Accident	100002179

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			1		2
Current Violations	1			1		2
Initial Penalty	$2,500	$0	$0	$2,500	$0	$5,000
Current Penalty	$1,875	$0	$0	$500	$0	$2,375
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	19100178 L01 I	04/08/2004	05/04/2004	$1,875	$2,500	$0	I - Informal Settlement
2.	01001B	Serious	19100178 L06	04/08/2004	05/04/2004	$0	$0	$0	I - Informal Settlement
3.	02001	Other	19040039 A	04/08/2004	04/13/2004	$500	$2,500	$0	I - Informal Settlement

Investigation Summary

Investigation Nr: 200001733

Event: 12/03/2003

Employee killed in fall from forklift

On December 3, 2003, Employee #1 was using FOPS of a small forklift to reach flooring material. He fell over 6 ft to the concrete floor, striking his head. He was killed.

Keywords: HEAD, STRUCK AGAINST, INDUSTRIAL TRUCK, FALL, CONCRETE

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	306702911			Fatality	Fracture	Supervisors, material moving equipment operators

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