State of California Departmen t o f Industrial Rela tions Division of Occupatio nal Safety and Heal th Fremont Distric t Office 391 41 Civic Center Drive, Suite 310 Fremont. CA 94538 Phone : (5 10) 794-2521 Fax: (510) 794-3889 Inspection #: IL3t433 Inspection Dates: 06/05/20 17 - 11/22/20 17 I I /28/20 17 Issuance Date: P7849 CSHO ID: Optional Report #: 030-17 Citation and Notification of Penalty Company Name: Mark Ill Construction Inc. Establishment DBA: and its successors Inspection Site: 45500 Fremon t Blvd Fremont. CA 94538 Ci tation 1 Item 1 Type of Violation: General T8 CCR Sec.§ 1509. Injury a nd Illness Prevention Program (a) Every employer shall establish, implement and maintain an effective Injury and Illness Prevention Program in accordance with section 3203 of the General Industry Safety Orders. §3203. Injury and Illness Prevention Program (a) Effective July 1, 1991, every employer shall establish, implement and maintain an effective Injury and Illness Prevention Program (Program) . The Program shall be in writing a nd, shall, a t a minimum: ( 1) Identify the person or persons with authority and responsibility for implementing the Program. Prior to and during the course of this investigation, including, but not limited to, on June 5, 2017 the employer failed to have establish an effective program in that its program did not iden tify the person(s) w ith responsibility for implementing the program. Corrected During Inspection Date By Which Violation Must be Abated: Proposed Penalty: Corrected During Inspection $800.00 s~e pages 1 lhrougr1 4 or tr,is Citation onrl t-loli'iccdion o 1 Penoi'y for informotion on employer oncl e.11ployee rights oncl respon\ibili'ies. Cito tion c1n -1N0r'ficor ::>n ' f Penalty Po~"" s of 13 Coi'OS. ,,.. -2 v' 0 ,..., 2/201 5 State of California Department o f Industrial Re lations Division of Occupational Safety and Health Fremont Dis trict O ffice 39 14 I C ivic Center Drive , Suite 310 Fremont, CA 94538 Phone: (51 0) 794-252 1 Fax: (51 0) 794-3889 Inspection #: Inspection Dates: Issuance Date: CSHO ID: Optional Report #: I '2-.!1 433 06/05/20 17 - I 1/22/20 17 11/28/2017 P7849 030- 17 Citation and Notification of Penalty Company Name: Mark Ill Construction Inc. Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd Fremont, CA 94538 Citation l Item 2 Type of Violation : General T8 CCR Sec.§ 1509. Injury and Illness Prevention Program (b) Every employer shall adopt a written Code o f Safe Practices which relates to the employer's operations. The Code shall contain language equivalent to the relevant parts of Plate A-3 of the Appendix. Prior to and during the course of this investigation, including, but not limited to, on June 5, 201 7 the employer fail ed to include procedures for working on energized equipment into the Code o f Safe Practices. Corrected During Inspection Dote By Which Violation Must be Abated: Proposed Penalty: Corrected During Inspection See pages 1 lnrough..: of ll1i; Cil( Jti.)f' a•1j No:if:co:·on of Penolry for information on employer and emp Cite. ron and NoE!ico';on of Penolry Page b of 13 $800.00 r''111'> onct responsibilir'es. Coi/OSHA-2 vI Re-., 2/20 I 5 )t-=?e State of California Department of Industrial Relations Division of Occupa tional Safety and Heal th Fremont Distric t Office 39 I 4I Civic Center Drive. Suite 3 tO Fremont. C A 94538 Phone: (5 I 0) 794-252 I Fax: (51 0) 794-3889 Inspection #: ll.Jt433 Inspection Dates: 06/05/20 I 7 - I I /22/ 20 I 7 Issuance Date: I I /28/20 17 CSHO ID: P7849 Optional Report It: 030-I 7 Citation and Notification of Penalty Company Name: Mark Ill Construction Inc . Establishment DBA: a nd its successors 45500 Fremont Blvd Inspection Site: Fremont, CA 94538 Cita tion 1 Item 3 Type of Violation: General T8 CCR Sec .§ 1670. Personal Fall Arrest Systems, Personal Fall Restraint Systems and Positioning Devices. (a) Approved personal fall arrest. personal fall restraint or positioning systems shall be worn by those employees whose work exposes them to falling in excess of 7 1/2 feet from the p erimeter of a structure, unprotected sides and edges. leading edges, through shaftways and openings, sloped roof surfaces steeper than 7:1 2, or other sloped surfaces steeper than 40 degrees not otherwise adequately protected under the provisions o f these Orders. Note: ( 1) Requirements relating to fall protection for employees working at elevated locations on poles, towers and other structures are provided in Section 2940.6(b) and (c) of the High Voltage Electrical Safety Orders. (2) Requirements relating to fall protection for e mployees working on poles, towers, or similar structures are provided in Section 8615(g) of the Telecommunications Safety Orders. (3) Require ments relating to fall protection for employees working in roofing operations are provided in Section 1730 of the Construction Safety Orders. Prior to and during the course o f this investigation, including, but not limited to, on June 5, 20 17 the employer failed to ensure that the employees were utilizing fall protection when being exposed to falls in excess of 7 1/2 feet while working on top of the paint dryers. Corrected During Inspection Date By Which Violation Must be Abated: Proposed Penalty: Corrected During Inspection $800.00 See pages I lhrough 4 of tnis Cik1tion oncl No lificotion o f Penally for information on employer and employe e rights ond respo nsibilities. Citation a"ct Noriicotion of Peno:•y Page 7 o f 14 Coi/OSH '\-2 V I Rev 2/20 15 State of California Department of tndustriat Relations Division of Occupational Sa fe ty and Heal th Fremont Distric t Office 39141 Civic Cen ter Drive, Suite 310 Fremont. CA 94538 Phone: (510) 794-2521 Fax: (51 0) 794-3889 Inspection #: tL~ -.33 Inspection Dates: 06/05/20 I 7 - 1 1/22/20 17 Issuance Date: 11/28/20 17 CSHO ID: P7849 Optiona l Report It: 030-17 Citation and Notificatio n of Penalty Company Name: Mark Ill Construction Inc. Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd Fremon t, CA 94538 Citation 2 Item 1 Type of Violation: Serious Accident Related T8 CCR Sec. §2320.1. General. (a) Only qualified persons shall work on electrica l equipment or systems. Prior to and during the course of this investigation, including. but not limited to. on June 5, 2017 the employer had a non-qualified person worki ng on energized electrical equipment. As a result the employee suffered serious injury from an arc flash. Corrected During Inspection Date By Which Violation Must b e Abated: Proposed Penalty: Corrected During Insp ection $18000.00 See poge5 I through 4 o f ll1is Citotion onct Notification of Penalty for information on employe• one! emoloyee rights and responsibilities. Citati-:m oncl N-:>tificol'·:>n o' Penalty Pogo s of 14 Cui/OSHA.-2 v 1 Rev 2/2015 Inspection #: 11..Jt433 Inspection Dates: 06/05/20 I 7 - I 1/22/20 17 Issuance Date: 11/28/2017 CSHO 10: P7849 Optional Report #: 030-1 7 State of California Department o f Industrial Relations Division of Occupational Sa fe ty and Health Fremont Distric t Office 391 41 Civic Center Drive, Suil e 310 Fremon t, CA 94538 Phone: (51 0} 794-2521 Fax: (51 0) 794-3889 Citation and Notification of Penalty Company Name: Mark Ill Construction Inc . Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd Fremont. CA 94538 Ci tation 3 1tem 1 Type of Violation: Serious Accident Related T8 CCR Sec . § 2320.2. Energized Equipment or Syste ms. (a) Work shall not b e performed on exposed e nergized parts of equipment or systems until th e following conditions are met: (3) Suitable personal protective equipment and safeguards (i.e ., approved insulated gloves or insula ted tools) are provided and used. Prior to and during the course of this investigation. including, but not limited to, on June 5, 201 7 the e mployer failed to provide the employee with suitable personal protective equipment a nd safeguards. As a result the emp loyee suffered serious injuries whe n exposed to an a rc flash. Corrected During Inspection Corrected During Inspection Date By Which Violation Must be Abated: Proposed Penalty: See pqg~s I through 4 of this Citari0n on(! No·irico··on ")f Ci·:~ '.c·n and 1 .ot'fic P J J~~ 9 :: · 13 Ccr!/0:-,H.<\·? '.' 1 r;e . 2120 'i State of California 1231433 Inspection #: Inspection Dates: 06/05/20 I 7 - I I /22/20 I 7 I 1/28/20 17 Issua nce Date: CSHO ID: P7849 Optional Report #: 030-17 Departm en t of Industrial Relatio ns Division of Occupatio nal Safety and Health Fremont District Office 391 41 Civic Center Drive. Suite 310 Fremont. CA 94538 Phone: (510) 794-252 1 Fax: (51 0) 794-3889 Citation and No tification of Penalty Company Name: Mark Ill Construction Inc. Establishment DBA: and its successors Inspection Site: 45500 Fremont Blvd Fremont, CA 94538 Citation 4 Item 1 Type of Violation: Serious T8 CCR Sec. §2320.2. Energized Equipment or Systems. (a) Work shall no t be performed on exposed energized parts of equipment or systems until the following conditions are met: (5) Suitable barriers or approved insulating material shall be provided and used to prevent accidental con tact w ith energized parts. Prior to and during the course of this investigation. including, but not limited to, o n June 5, 2017 the employer failed to provide a suitable barrier to prevent accidental contact with energized parts. Corrected During Inspection Date By Which Violation Must b e Abated: Proposed Penalty: See poges 1 lhrough 4 of 1!1is Citotior. on.l Cita tion and :-.Jotif'cotionofPe'lal'/ ~J otifico'ion Corrected During Inspection $7200.00 of Penoliy fo· informotion on employer arY't ernplo•;ee rigrots O'Kl responsibilities. Poge LOot 13 C :"OS~'\-2 VI Pe·,2/2Gi5 Inspection #: 123t433 Inspection Dates: 06/05/20 I 7 - 11/22/20 17 Issuance Date : 11/28/2017 P7849 CSHO ID: Op tional Report#: 030- 17 State of California Deportment of Industrial Relations Divisio n of Occupa tional Safety and Health Fremon t District Office 39141 Civic Center Drive. Suite 3 10 Fremont. C A 94538 Phone: (51 0) 794-252 1 . Fox: (51 0) 794-3889 Citation and Notification of Penalty Company Name: Mark Ill Construc tion Inc. Establishment DBA: a nd its successors Inspection Site: 45500 Fremont Blvd Fremo nt, CA 94538 C ita tion 5 Item 1 Type of Violation : Serious T8 CCR Sec. §2320.2. Energized Equipment or Sys tems. (a) Work shall not be performed on exposed energ ized parts of equipment or systems until the following conditions are met: (8) Each employee who is exposed to the hazards of flames or elec tric arcs wears apparel that. when exposed to flames or electric arcs, does not increase the extent of injury that would be sustained by the employee. This subsection prohibits clothing made from the following types of fabrics, either alone or in blends, unless the employee can demonstrate that the fabric has been treated with flame retardant: acetate, nylon, polyester. and rayon. Prio r to and during the course of this investigation, including, but not limited to, on June 5, 2017 the employer failed to provide the employee with apparel that would not increase the extent of injury wh en exposed to the hazards of a flame or electric arcs. · Corrected During Inspection Corrected During Inspection $7200.00 Date By Which Violation Must be Abated: Proposed Penalty: ~~ ,OI)r- ______;-:J"-'-"""---zJ.cKelly Tatum · Compliance Officer I District M a nager See p a ges 1 through 4 of tl>is Citotion nc d Citation O'lCI Nol'ficoticr' of "'e'lwy ~J,) tificotinn of Penalty for informotion on employer on·-1 Poge LL of 13 Pr11p oyee dul1b oncl responsib:lities. Co t()SHq-2 v :>,_., 2/2015 STATI- OF CAI luuy Drawn Cow-mm DEPARTMENT or INDUSTRIAL RELATIONS DIVISION OF OCCUPATIONAL SAFETY AND HEALTH 39141 Center Dr Sune 310 Fremont CA 94538 (510: 79472521 FAX (510', 794 3889 I: I-atahty Narrative Summary FEstainshment Name: Mark Consfiuction. Inca Inspection Number: 1237433 Management Contented: 7 Title: Dan Canton 7 7 7 7 7 7 Presudent 7 Informatlolon Injured Covered by Workers700mpensatlon7 Ves 37 No: Name: Son en I Occugat ElectricianTrainee 7 IK- :nnuzitavmt Hm": I Wrtnese Names and hue 7 7 77 Name and Title 7 PhoriNumber 7 Superv/sor irmnee if Js: Milt 2 hr"; as 'va 1 Locatlorlotziccldent 45500 Fremont FremontCA ?4538 2 Date was notified 7 J7une 5 2917 7 7 7 3 Date Amved at Slte June 5. 2077 7 7 4 Wm Automotlve manufacturing 77 5 Manner how FE was Arc Flash inLured/exposed 7 7 7 I 6 Hospital injured was taken to wi/aIley MedrcaI Burn Unit 7 7 Type of Injury7or 7 Second and Third degree burns 7 7 8 Name 0! Immediate I 7 7 7 ram 7'1: A new -2 Ma; Summary Introduction June 5 2317 e: acpwmale 110 60AM an amp ct Mark Contractor; Inc was wan a bus plug on lap uIdH even a! 45500 Fvemnnt Fremum CA 94538 when an arc Hash occurred Reporting Reg ments The en'playew contact the waswuv' un rune 5 7m? at aupmxunater v1 06AM arm mom-a Ihern or we acme." The employee suIlP'e: seccnd and mu degree burrs to [are :t-est am's awn: nan-:5 're DH 5 or ar'wec on scene 0" a 23" at appraxw'areiy '2 30PM to scan :he Invesl gamn Conditions and Factors to Accident: The employee (an electrician trainee) was on top of an automotive oven wiring in a bus plug (TT25-3), he had all wires attached except for the upper ground wire. When attempting to connect the ground wire something occurred and caused an arc flash, pushing the employee back approximately 15 to 20 feet and catching his clothing on fire. The employee's immediate supervisor and another electrician trainee were removing equipment (Tugger) from the tops of the oven and taking them down stairs. When the accident occurred the supervisor and other trainee went up to help the injured employee. The supervisor started putting out small fires in the area and using his cell phone he called for help, the other trainee went to the inju red employee and helped him off of the oven by means of a scissor lift and walked him down stairs and then outside to a shaded area where an ambulance came and took him to the hospital. Causes and Conclusions : The employee was an electrician trainee and was not qualified to be working on this equipment unsupervised. The bus duct was energ ized, there was not a sufficient barrier between the bus duct and bus plug , and the employee was not provided the personal protective equipment and safe guards required for this job. Citations Issued : T8 CCR Sec. §2320.1. General. Serious Accident Related (a) Only qualified persons shall work on electrical equipment or systems. Prior to and during the course of this investigation, including, but not limited to, on June 5, 20 17 the employer had a non-qualified person working on energized electrical equipment as a result the employee suffered serious injury from an arc flash. T8 CCR Sec. §2320.2. Energized Equipment or Systems. Serious (a) Work shall not be performed on exposed energized parts of eq uipment or systems until the following conditions are met: (3) Suitable personal protect ive equipment and safeguards (i.e., approved insulated gloves or insulated tools) are provided and used. Prior to and during the course of th is investigation, including, but not limited to, on June 5, 20 17 the employer fai led to provide the employee with suitable personal protective equipment and safeguards. As a result the employee suffered serious injuries when exposed to an arc flash. T8 CCR Sec. §2320.2. Energized Equipment or Systems. Serious (a) Work shall not be performed on exposed energized parts of equipment or systems until the following conditions are met: {5) Suitable barriers or approved insulating material shall be provid ed and used to prevent accidental contact w ith energized parts. Prior to and during the course of this investigation, including, but not limited to, on June 5, 20 17 the employer failed to provide a suitable barrier to prevent accidental contact with energized parts. T8 CCR Sec. §2320.2. Energized Equipment or Systems. Serious {a) Work shall not be performed on exposed energized parts of equipment or systems unt il the following conditions are met: {8) Each employee who is exposed to t he hazards of flames or electric arcs wears appa rel that, when exposed to flames or electric arcs, does not increase the extent of injury that would be sustained by the employee. This subsection prohibits clothing made from the following types of fabrics, either alone or in blends, un less the employee can demonstrate that the fabric has been treated with f lame retardant: acetate, nylon, polyester, and rayon. Prior to and during the course of this investigation, including, but not limited to, on June 5, 2017 the employer failed to provide the employee with apparel that would not increa se the extent of injury when exposed t o the hazards of a flame or electric arcs. Title Prepared by: Associate Safety Engineer Reviewed by: District Manager Reviewed by: Sr. SEIIH Reviewed by: Reg ional Manager