Inspection Detail

Inspection: 308565985 - Mn Conference Of Seventh Day Adventists

Inspection Information - Office: Minnesota Department Of Labor And Industry

Inspection Nr: 308565985

Report ID: 0552700

Date Opened: 01/11/2005

Site Address:
Mn Conference Of Seventh Day Adventists
1220 S Mcknight Rd
Maplewood, MN 55119

Mailing Address:
7384 Kirkwood Ct, Maple Grove, MN 55369

Union Status: NonUnion

SIC:8211

NAICS: 611110/Elementary and Secondary Schools

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 04/22/2005

Emphasis:

Case Closed: 11/03/2009

Related Activity
Type	Activity Nr	Safety	Health
Accident	100510478

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			1		2
Current Violations	1			1		2
Initial Penalty	$25,000	$0	$0	$2,500	$0	$27,500
Current Penalty	$25,000	$0	$0	$0	$0	$25,000
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	19100029 A03 I	05/02/2005	05/06/2005	$25,000	$25,000	$0	05/19/2005	F - Formal Settlement
2.	02001	Other	19040039 A	05/02/2005	05/06/2005	$0	$2,500	$0	05/19/2005	F - Formal Settlement

Investigation Summary

Investigation Nr: 200513661

Event: 12/23/2004

Employee Is Killed While Removing Ceiling Light Fixture

On December 23, 2004, Employee #1 was removing a temporary light fixture from the ceiling area of a gym. Employee #1 was 19 ft above ground using an Up-Right Tallescope unit to access the light fixture. While removing the light fixture, Employee #1 fell off the unit. Employee #1 failed to lock the wheels and extend the outriggers on the unit. There were no witnesses to the accident, and it is believed that Employee #1 tried to jump onto the stage as the unit was falling over, hit the stage and landed on the concrete floor. Employee #1 was able to drag himself several feet before he died.

Keywords: WHEEL, MAINTENANCE, OUTRIGGER, INDUSTRIAL TRUCK, PIT, FALL

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	308565985			Fatality	Other	Occupation not reported

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