Inspection Detail

Inspection: 313511701 - Jensen Enterprises Inc Dba Jensen Precast

Inspection Information - Office: San Bernardino District Office

Inspection Nr: 313511701

Report ID: 0950633

Date Opened: 02/15/2011

Site Address:
Jensen Enterprises Inc Dba Jensen Precast
14221 San Bernardino Ave
Fontana, CA 92335

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:3272

NAICS: 327390/Other Concrete Product Manufacturing

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 06/06/2011

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 05/23/2014

Related Activity
Type	Activity Nr	Safety	Health
Accident	102615671

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				1		1
Current Violations				1		1
Initial Penalty	$0	$0	$0	$750	$0	$750
Current Penalty	$0	$0	$0	$0	$0	$0
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	3328 E	06/06/2011	06/09/2011	$0	$750	$0	06/14/2011	F - Formal Settlement

Investigation Summary

Investigation Nr: 202633582

Event: 12/10/2010

Mold Wall Falls and Injurs Employee

At approximately 5:30 a.m. on December 10, 2010, Employee #1 was engaged in stripping the form walls of concrete. Employee #1 hooked the crane cables to the top eyelet on the form walls. Employee #1 started removing chains, safety pins and bolts from the form walls. While doing so, Employee #1 inadvertently removed the safety pins and chains from below the form wall. As Employee #1 was removing the last top bolt at the northeast corner, the east form wall separated and started falling down, pinning Employee #1 underneath. This accident resulted in serious physical injuries to his lower back and right knee.

Keywords: CHAIN, FRACTURE, WALL, BACK, BOLT, FALL, STRUCK BY, LEG

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	313511701			Hospitalized injury	Bruise/Contus/Abras	Production helpers

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