Inspection Detail

Inspection: 310600960 - Wal-Mart Distribution Center #7033

Inspection Information - Office: San Bernardino District Office

Inspection Nr: 310600960

Report ID: 0950633

Date Opened: 11/29/2007

Site Address:
Wal-Mart Distribution Center #7033
21101 Johnson Rd
Apple Valley, CA 92307

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:5311

NAICS: 452112/Discount Department Stores

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 04/16/2008

Emphasis:

Case Closed: 03/24/2010

Related Activity
Type	Activity Nr	Safety	Health
Accident	102548104

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1					1
Current Violations				1		1
Initial Penalty	$18,000	$0	$0	$0	$0	$18,000
Current Penalty	$0	$0	$0	$300	$0	$300
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	Other	3650 T09	04/18/2008	05/06/2008	$300	$18,000	$0	04/29/2008	F - Formal Settlement

Investigation Summary

Investigation Nr: 202446910

Event: 10/22/2007

Employee Suffers Amputated Leg When Lift Truck Crashes

At approximately 10:00 p.m. on October 22, 2007, Employee #1, an Operations Manager, was helping the B2-crew organize a special project at the Staple Stock Receiving area and had been on the lift truck approximately an hour when the accident occurred. Witnesses observed Employee #1 trying to stop the lift RR Unit Number 021 Reach Lift truck (Model Number RR 5220-45, SR Number 1A265179) from running into an I-beam by the west t east aisle. Employee #1 was using his left hand and left leg in the attempt, and when the lift truck struck the I-beam Employee #1 sustained an amputation of his left leg from above the knee. Employee #1 was hospitalized for fifteen days.

Keywords: BEAM, AMPUTATED, WAREHOUSE, STRUCK AGAINST, AERIAL LIFT, LEG

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	310600960			Hospitalized injury	Amputation	Personnel and labor relations managers

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