Translate
Violation Detail
Standard Cited: 19040029 B02 Forms.
Inspection Nr: 1053506.015
Citation: 02002
Citation Type: Other
Abatement Date: 11/22/2016 2
Initial Penalty: $1,100.00
Current Penalty: $700.00
Issuance Date: 07/21/2015
Nr Instances: 1
Nr Exposed: 3800
Related Event Code (REC):
Gravity:
Report ID: 0523900
Contest Date: 08/04/2015
Final Order: 07/25/2016
Emphasis:
| Type | Latest Event | Event Date | Penalty | Abatement Due Date | Citation Type | Failure to Abate Inspection |
|---|---|---|---|---|---|---|
| Penalty | F: Formal Settlement | 07/25/2016 | $700.00 | 11/22/2016 | Other | |
| Penalty | C: Contested | 08/04/2015 | $1,100.00 | 08/04/2015 | Other | |
| Penalty | Z: Issued | 07/21/2015 | $1,100.00 | 08/04/2015 | Other |
Text For Citation: 02 Item/Group: 002 Hazard:
29 CFR 1904.29(b)(2): The employer did not fill out or correctly fill out an OSHA Form 301 or equivalent for each recordable injury or illness: Ashley Furniture Industries, Inc. - One Ashley Way, Arcadia, WI. On or about April 13, 2015, an OSHA Form 301 or equivalent for the following work-related injuries or illnesses was not filled out or incorrectly filled out for the calendar year 2015: (a) On or about March 11, 2015, an employee was performing a pre-shift preventative maintenance check on dovetail machine WD213 when the back of the employee's right hand contacted a spinning groover blade, Case number 15166, resulting in an amputation. The worker's compensation form, WKC-12, that the employer uses as an equivalent to the OSHA Form 301 did not contain the name of the treating practitioner, that the employee was hospitalized overnight as an in-patient, and an accurate description of the injury.