Inspection Detail

Inspection: 306741307 - Avery Dennison

Inspection Information - Office: Avenel Area Office

Inspection Nr: 306741307

Report ID: 0213400

Date Opened: 05/17/2004

Site Address:
Avery Dennison
3 Fitzgerald Ave.
Monroe Twp., NJ 08831

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:4212

NAICS: 484220/ Specialized Freight (except Used Goods) Trucking, Local

Inspection Type: Referral

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 07/02/2004

Emphasis: L:Forklift

Case Closed: 08/17/2004

Related Activity
Type	Activity Nr	Safety	Health
Referral	201318359	Yes

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	2					2
Current Violations	2					2
Initial Penalty	$5,000	$0	$0	$0	$0	$5,000
Current Penalty	$3,750	$0	$0	$0	$0	$3,750
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	Serious	5A0001	07/02/2004	07/08/2004	$1,875	$2,500	$0		I - Informal Settlement
2.	01002	Serious	5A0001	07/02/2004	07/08/2004	$1,875	$2,500	$0		I - Informal Settlement

Investigation Summary

Investigation Nr: 201311214

Event: 05/17/2004

Employee is injured when forklift falls from trailer

Employee #1 was operating a forklift in a trailer. The trailer began to creep away from the dock and the forklift fell out of the back of the trailer. The employee was hospitalized with lacerations.

Keywords: EQUIPMENT OPERATOR, STRUCK AGAINST, INDUSTRIAL TRUCK, LACERATION, FALL, TRAILER, LOADING DOCK, INATTENTION

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	306741307			Hospitalized injury	Cut/Laceration	Occupation not reported

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