Inspection Detail

Case Status: CLOSED

Inspection: 1540689.015 - 103110 - Jd Peterick Inc Dba Northwest Asphalt - Maint

Inspection Information - Office: Minnesota Department Of Labor And Industry

Inspection Nr: 1540689.015

Report ID: 0552700

Date Opened: 07/01/2021

Site Address:
103110 - Jd Peterick Inc Dba Northwest Asphalt - Maint
16761 Marschall Road
Shakopee, MN 55379

Mailing Address:
11560 190th Street Ne, Thief River Falls, MN 56701

Union Status: NonUnion

SIC:

NAICS: 237310/ Highway, Street, and Bridge Construction

Inspection Type: Fat/Cat

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 08/06/2021

Emphasis:

Case Closed: 08/17/2021

Related Activity
Type	Activity Nr	Safety	Health
Accident	1782738

Case Status: CLOSED

Investigation Summary

Investigation Nr: 137008.015

Event: 07/01/2021

Employee is struck by motor vehicle and later dies

At 12:00 p.m. on June 28, 2021, an employee worked as a flagger for a road crew sealing road cracks. At some point, a motor vehicle swerved and struck the employee who was taken to the hospital for treatment. The employee was transferred to another hospital and died a few days later.

Keywords: Flagger, Motor Vehicle, Road, Struck By

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	1540689.015	59	M	Fatality		Occupation not reported

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