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Inspection Detail

Inspection: 315530824 - Westminster Superstore Llc Dba Westminster Superst

Inspection Information - Office: Santa Ana District Office

 

Inspection Nr: 315530824
Report ID: 0950631
Date Opened: 09/22/2012

Site Address:
Westminster Superstore Llc Dba Westminster Superst
15440 Beach Blvd Suite 128
Westminster, CA 92683

Mailing Address:
15440 Beach Blvd Suite 128, Westminster, CA 92683

Union Status: NonUnion

SIC:5411

NAICS: 445110/Supermarkets and Other Grocery (except Convenience) Stores

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 12/18/2012

Emphasis:

Case Closed: 11/17/2017

Related Activity
Type Activity Nr Safety Health
Accident 102815446
Violation Summary
Violations/Penalties Serious Willful Repeat Other Unclass Total
Initial Violations 4 6 10
Current Violations 4 6 10
Initial Penalty $52,650 $0 $0 $4,125 $0 $56,775
Current Penalty $37,260 $0 $0 $3,280 $0 $40,540
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 3203 A 01/07/2013 01/10/2013 $325 $400 $0 01/25/2013 F - Formal Settlement  
2. 01002 Other 3650 T01 01/04/2013 01/09/2013 $365 $450 $0 01/25/2013 F - Formal Settlement  
3. 01003 Other 3650 T17 01/07/2013 01/10/2013 $480 $675 $0 01/25/2013 F - Formal Settlement  
4. 01004 Other 3650 T26 01/07/2013 01/10/2013 $810 $1,000 $0 01/25/2013 F - Formal Settlement  
5. 01005 Other 3657 I 01/07/2013 01/10/2013 $650 $800 $0 01/25/2013 F - Formal Settlement  
6. 01006 Other 3668 D02 01/07/2013 01/10/2013 $650 $800 $0 01/25/2013 F - Formal Settlement  
7. 02001 Serious 3657 B02 01/07/2013 01/10/2013 $20,250 $20,250 $0 01/25/2013 F - Formal Settlement  
8. 03001 Serious 3657 E 01/07/2013 01/10/2013 $8,100 $8,100 $0 01/25/2013 F - Formal Settlement  
9. 04001 Serious 3646 B 01/07/2013 01/10/2013 $810 $8,100 $0 01/25/2013 F - Formal Settlement  
10. 05001 Serious 3646 E 01/07/2013 01/10/2013 $8,100 $16,200 $0 01/25/2013 F - Formal Settlement  

Investigation Summary

Investigation Nr: 202554853
Event: 09/22/2012
Employee Is Killed in Fall from Scissor Lift

On September 22, 2012, Employee #1 was changing light bulbs on the outside of a market. He was using an upright MX19 scissor lift on the forks of a Toyota model 42-FGCU15 forklift to access the light fixtures. The scissor lift was extended to a height of 22.33 ft. As he went to change a bulb, the scissor lift tilted and fell off the forks. Employee #1 fell to the asphalt parking lot and sustained head injuries that killed him.

Keywords: HYDRAULIC LIFT, INSTALLING, LIGHTING FIXTURE, FALL, UNSTABLE POSITION

Investigated Inspection
# Inspection Age Sex Degree of Injury Nature of Injury Occupation
1 315530824 Fatality Fracture Managers and administrators, n.e.c
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