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Inspection Detail
Inspection: 314616970 - Sam'S Club, Store #6442
Inspection Information - Office: Bridgeport Area Office
Site Address:
Sam'S Club, Store #6442
2 Boston Post Road
Orange, CT 06477
Mailing Address:
, , 00000
Union Status: NonUnion
SIC:5311
NAICS: 452112/Discount Department Stores
Inspection Type: Referral
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 11/30/2010
Emphasis: L:Forklift, S:Powered Ind Vehicle
Case Closed: 03/28/2011
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Referral | 202631081 | Yes |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 6 | 7 | |||
| Current Violations | 6 | 6 | ||||
| Initial Penalty | $5,000 | $0 | $0 | $9,000 | $0 | $14,000 |
| Current Penalty | $0 | $0 | $0 | $5,750 | $0 | $5,750 |
| FTA Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| # | Citation ID | Citaton Type | Standard Cited | Issuance Date | Abatement Due Date | Current Penalty | Initial Penalty | FTA Penalty | Contest | Latest Event | Note |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | 01001 | Serious | 19100178 L03 IIG | 11/30/2010 | 12/24/2010 | $0 | $5,000 | $0 | I - Informal Settlement | Citation has been deleted. | |
| 2. | 02001 | Other | 19040029 B01 | 11/30/2010 | 12/24/2010 | $500 | $1,000 | $0 | I - Informal Settlement | ||
| 3. | 02002 | Other | 19040029 B01 | 11/30/2010 | 12/24/2010 | $500 | $1,000 | $0 | I - Informal Settlement | ||
| 4. | 02003 | Other | 19040029 B02 | 11/30/2010 | 12/24/2010 | $500 | $1,000 | $0 | I - Informal Settlement | ||
| 5. | 02004 | Other | 19040029 B02 | 11/30/2010 | 12/24/2010 | $500 | $1,000 | $0 | I - Informal Settlement | ||
| 6. | 02005 | Other | 19100305 B01 II | 11/30/2010 | 12/03/2010 | $0 | $0 | $0 | I - Informal Settlement | ||
| 7. | 02006 | Other | 19100178 L03 IIG | 11/30/2010 | 12/24/2010 | $3,750 | $5,000 | $0 | I - Informal Settlement |
Investigation Summary
At approximately 8:40 p.m. on July 11, 2010, a truck backed up to the dock, with the dock plate lip resting on the end of the truck bed. The vendor was delivering a shower tub display piece. The dimensions of the display piece were 36-in. wide, 84.5-in. long, 84.5-in. high, and weighed 575 lbs. The display piece had wheels on it. To unload the display piece, the vendor's Project Manager, and Employee #1, closing Manager stood on each side of the display piece on the flat bed of the truck. With a Crown Model 3020-30 Stand up forklift, Employee #2, a forklift operator, moved the forklift forward toward the edge of the dock plate to get the fork tips under the display piece. Employee #2 continued to move the forklift truck forward and as the forks came under the display piece the forklift was moving onto the back of the truck bed. The forklift moved forward and the truck began to move forward then the forklift fell off the dock. Employee #2 landed partially on the dock with his right leg caught between the overhead guard of the forklift and the dock. Employee #1 fell off the right end side of the flatbed truck. Employee #2 sustained a head injury and broken bones and was hospitalized. Employee #1 experienced some pain but was not hospitalized.
Keywords: FRACTURE, DOCK, CAUGHT BETWEEN, INDUSTRIAL TRUCK, FALL
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 314616970 | Hospitalized injury | Fracture | Occupation not reported |