Document emaO3vB59xgR9L2X0qYgkRdVp

t (( MONSANTO COMPANY TEXAS CITY, TEXAS FEBRUARY 7, 1966 ACCIDENT ANALYSIS MONTHLY BULLETIN JANUARY,, 1966 HIGHLIGHTS The 1966 Control Charts have been changed in that the goal line shown is the 1965 performance. This may or may not be the best previous year's performance. This change pro vides for comparison of trend changes during 1966 to data which is current and more realistic. The total number of incidents reported during January were above the number reported for the same period last year. More Slips and Falls incidents are expected to occur during February and March than for any other period during the year. Departmental safety meetings and personal contact safety talks should cover prevention of this type accident. : ps Attachments CBY 1018208 RSV0032549 3000 m 1 i -i i J a 2000 Q. MONSANTO COMPANY TEXAS CITY PLANT 1966 TOTAL INJURIES PAST HISTORY 1957 1958 1959 i960 1961 1962 1963 1964 1965 4446 3746 3368 3041 2883 2313 2064 2142 1769* -3000 -2000 * * .1000 - e i ? CBV 1018209 -1000 JAN. FEB. MAR. APR. MAY JUNE JULY AUG. SEPT. u OCT. NOV. DEC. 0 RSV0032550 Cumulative Monthly Injury Rate - Injuries Per M illio n Manhours MONSANTO COMPANY TEXAS CITY PLANT 1966 SERIOUS INJURIES RSV0032551 1000' i ooH i j i 6oo- PAST HISTORY 1957 1958 1959 i960 1961 1962 1963 1964 1965 1243 1094 1110 824 891 774 581 586 473* MONSANTO COMPANY TEXAS CITY PLANT 1966 CAUSE - STRIKING AGAINST 1000 - 8oo - 600 4400- 1 i foo- dI - 400 CBY 1018211 - 200 JAN. PEB. MAR. APR. MAY JUNE JULY AUG. SEPT. OCT. NOV. DEC. RSV0032552 MONSANTO COMPANY TEXAS CITY PLANT 1966 CAUSE - STRUCK BY RSV0032553 Cum ulotivt Monthly Injury Rot* ln |u ri*t P *r M illion Manhour* Expoturo 250 200 150- PAST HISTORY 1957 1958 1959 i960 1961 1962 1963 1964 1965 416 273 231 230 219 185 162 175 127* MONSANTO COMPANY TEXAS CITY PLANT 1966 CAUSE - CAUGHT BETWEEN - 250 - 200 - 150 100- - 100 50- n c. JAN. FEB. f-" I - 50 MAYJUNEJULYAUGT CBV 1018213 1 I) SEPT.OCT. HoV. DEC RSV0032554 Cumulotlvo Monthly Injury Rot* - -jjp ju ri# * Pur M illion Mijnjtours Exposure 2005000- MONSANTO COMPANY TEXAS CITY PLANT 1966 CAUSE - SLIPS AND FALLS PAST HISTORY 1957 1958 1959 i960 1961 1962 1963 1964 1965 200 142 179 177 127 147 143 188 123* - 200 - 150 ..-T` 100 I. CQ y i iOi - 50 JAN. FEB. MAR. APR. MAY JUNE JULY AUG. SEPT. OCT. NOV. DEC. RSV0032555 MONSANTO COMPANY TEXAS CITY PLANT 1966 CAUSE - TEMPERATURE EXTREME I - 300 - 250 Cumulative Monthly Injury Rot* - - Injuries Per M illio n Monhours 100 JAN. F. MAR. APR. MAY JUNE JULY AUG. j 1018215 I 1 J I SEPT. OCT. NOV.DEC. 50 0 RSV0032556 MONSANTO COMPANY TEXAS CITY PLANT 1966 CAUSE - CHEMICAL CONTACT RSV0032557 Cumulotiv* Monthly Injury Roto - Injurie* Per M illio n Monheurs Expotur* MONSANTO COMPANY TEXAS CITY PLANT 1966 CAUSE - LIFTING-PUSHIMG-PULLING 250 200 150 100 50 0 RSV0032558 OCtlha- STRIKE STRl-CK Tir\ against hv OPERATOR AN A l YSI 7 ft 3 ft PUKt-R (.ARP 1 t GUARD 0H cate ter i a ft ft JANI TOR 11 insulator BOILERPaKR 1ft C 7 1RCNNOH KFP 0 i' CARPENTER 7 3 ELtCTRlrN 0 ( PA INTFR 1? macmmrt 3 4 SHEET MFTL BXEKF i 1 TER 0 1 f 1 'HFR 10 cue * 03 IN'-rw man 0 0 OPFR FNGR ft ft STCRES-UMS n r ENbR A 1nE n 0 LAE TEO 0( MIST NLNEX n 0 CLth ICAl P1 P PL 1 ENG EX DIn ENG EX OPEN EX CTEER EX n n u n n ti 0 0 r c r n PI SNR SER RESROM FX TOT L TO PATE n n 13 13 r i i3 i3 MINOR INJURY AND ACCIDENT REPORT JANUARY 1066 ACCIDENT TYPE BY OCCUPATION OF INJURED n AUlaH r 1N/biWN 2 u u 0 u 0 u 1 u 1 u 0 u u u 1 y i) u 0 0 1 u u u 0 u tf c u u 6 o SLIPS r ALLS 1 0 0 0 0 D 0 0 0 0 0 1 c n l 0 0 0 0 n 0 0 0 0 0 0 0 n 0 0 0 3 3 TEMP extr 0 0 0 0 ft 0 c ft 0 ft 0 0 3 ft 1 ft 0 ft 0 n i n n 0 0 0 ft n 0 0 0 3 3 INHALA TION 0 D n 0 a 0 0 0 c 0 0 0 a 0 0 0 D 0 0 0 0 D 0 0 0 0 0 a 0 0 0 0 1 ELECT. cont 0 0 0 0 n 0 0 ft 0 0 ft n 0 ft 0 0 ft 0 ft ft ft 0 n d 0 0 ft ft 0 ft ft n 0 CHEM CONT 2 0 0 0 0 0 0 0 0 0 0 0 0 D 2 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 6 6 lifting ETC. ft 0 1 ft 0 0 0 0 0 ft 0 0 0 0 2 0 1 0 0 0 0 0 0 ft 0 0 0 0 0 D 0 4 4 N.E.C. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ACC. THIS MO 8 0 ?. 0 0 ? 1 3 0 4 0 4 8 ft 6 ? 2 0 0 ft 1 1 0 ft ft 1 0 0 0 0 1 48 0 ACC. ACC.TO LAST mo DATE 10 8 00 02 00 00 12 01 63 00 24 00 14 48 00 68 12 12 30 00 10 01 01 00 10 00 01 00 10 00 00 11 39 48 0 48 NO. OF EMP . 4-6 2 6*1 38 14 12. 33 14 48 Z 18 30 20 90 0 117 57 23 53 "7 3b 3U 53 14 153 15 5 9o 0 62 83 53 24 1888 INJ./ EMPL 0.017 0. 0.053 0. n. 0 '1 o'.. j3 0.062 0. 0.222 0. 0.200 n.089 0. 0.068 0.035 0.080 0. n, n. 0.033 0.019 0. o._ 0 o ', u 10 0. 0. 0. 0. 0.042 0.025 CBY 1018218 RSV0032559 MINOR INJURY A*10 ACCIDENT REPORT JANUARY 196ft ACCIDFNT TYPfc BY SCFNF OF ACCIOENT LOCA- STRlufc STRt CK T1 ( ^ AGAINST HY DEFT 1 DEFT 2 n 11 00 DEM 3 0C 06 FT 4 nn OEM 6 n0 1 CRACKING 0 V DEPT 7 00 DEFT 8 00 DEH 10 ?0 DEPT 11 00 DEFT 16 01 DEFT17-18C 1 0 DEFT 18P 0 l DEFT }C 0D DEPT ?G 00 06FT21-?2 fl 2 DEFT 23 10 OEM 24 0 (1 DEM 2^ 00 DEFT 26 0D DEFT 31 20 OEM 41 f. fl DEFT *c \1 OEM 43 0f MAIN OFFC tl 0 DFtr annex 0 p RF'-paCh 11 1 CCNTR LAB 0 fl PE 1 AR ft l> STrots surps 1) fl 3J Intk Shop P p DOCKS 1l trlcx Rack n 1 t.CaR Rack n e PO-Frt 1 ti i POWER c POwpH 3 0i 00 util other D o Sa< VAOE streets p< 0i Y A KPS W 41 K n f NORTH fen NORTH 6A 0t f (. LCCKH bi no n 1 GA 1F HLHSF ii 1* M|-.f ha|PT 7 1 Pll Cl-hPti >1 ( 6N14 FAf11 ft P f F F RATKS 0 l HAFWHOLCt-^ ft l DEM 33 fl 1 DEFT 34 ft ( DEFT 3* pr TOTAL 13 1 * TO flATfc 11 l > CAOUhT SLIPS IW/dlHN falls 00 l) 0 t> 0 00 00 U6 11 0 tl 0 10 0 fl <J 0 10 Ue U0 0 l) 0fl c0 uR 00 0 Cl 00 10 u2 00 u0 u0 10 00 00 00 10 00 0 fl a fl 00 i0 u ft u0 l) 0 nn t) 1 u0 ii 3 up u0 c0 u0 u0 u fl u ft 1) 0 u ft u0 u0 6l o4 TFPP 6XTR 0 4fl 0fl 0 0 0 0 r ci i 0 0 0 fl (1 n 0 0 0 0 0 0 0 0 0 0 0 0 fl 0 D 0 0 fl 1 0 0 0 n fl fl 0 I) fl 0 0 0 c 0 n l a 3 3 INHALA TION 0 f0l 0 0 fl fl 0 0 fl fl fl fl <1 0 fl fl 0 fl 0 0 fl fl 0 0 0 0 0 0 0 0 fl 9 0 0 0 0 0 9 0 0 0 0 ft ft 0 ft fl fl 0 n 0 0fl 9ft El EOT, Cfl ONT ff0ll fl fl 0 0 0 0 0 n 0 (1 n 0 0 0 0 0 n 0 0 fl 0 0 a n 0 0 fl fl ft fl fl B fl 0 n n ri n 0 ft n 0 fl ri 0 ft n P fftl n o CHEM CONT 0 0 0 0 0 e 0 0 6 0 0 1 fl 1 0 0 0 0 0 0 0 0 0 0fl 0 1 0 0 0 0 9 0 fl e 0 fl 0 0 0 9 fl 0 0 0 fl 0 3 0 e 0 0 0 0 6 6 LIFTING ETC. fl fl 0 0 0 ft 0 0 0 fi 0 fl n 0 ci 0 0 0 0 0 0 0 0 0 0 0 0 0 n 0 1 0 fl B 2 0 0 0 0 fl ft 0 fl fl n n 1 n 0 0 0 0 0 0 4 4 N.E.C. f0l 0 0 0 t e t 0 C 0 0 0 J 0 0 0 0 o 0 0 0 0 0 9 9 0 0 0 9 0 0 0 0 0 0 0 fl 0 0 0 0 0 0 0 fl fl 0 0 0 0 0 0 0 0 0 ACC. THIS MO 0 0 0 9 9 9 0 ft 3 0 1 4 0 1 0 2 1 0 0 0 2 1 4 0 fl 0 3 0 0 0 0 0 1 1 2 1 ? 0 ft 0 7 0 fl o a ft 4 3 0 ft fl ) 1 fl 4fftt aCC . ACC.TO LAST MO DATE 00 00 10 00 10 00 10 10 13 00 21 04 1Q 01 20 22 01 00 00 o0 fl 2 61 74 00 fl 0 00 23 10 fl 0 10 4e 10 0i fl i 02 01 12 00 00 00 02 00 00 00 00 10 24 03 00 00 fl 0 01 01 1o 39 48 0 48 cay 10aS2i9 RSV0032560 Lflr*- STRIKE STfilOK Tim against T deft 1 DEf- r ? 0c n ft CFFT 3 OFrT 4 OFPT % CL (1 \ 1) V 1 fkACKINK i ft OF?- r 7 0f OF? T 8 0 11 DFn 3d <1 C OF?1 3 \ nl OFF 1 36 0 ft DFM 17-1BC i l dfft 16P 0e OFFT 1* 0 i. OF F r 2U 0 <i 0FKT21-92 0 n DEPT ?3 n0 OFFT ?4 00 OEPT 2*1 n0 DEFT 2fc n0 DEFT JI 0 ft DFFT AT 00 DEFT <2 1i DEFT 4* 00 MiK OFFC (i 0 OFfr ANNE* n r RESFARCh (i y COKTH LA0 ft ft Rf \k* STi -ibS r f. n ft Si-ms pi tNJ-TH iMCP n t DOCKS 0 ft TRUCK RACK T,CAf* FAC POWER 1 0 n n t C t POkFH i POuefl * 0c a ft UTfi OTHER n ( Salvage n t' STWFgTi TARnS-kAlK NORTH Bn ft ii ii l f 1 NORTH e LOPR btHfl n ft { 1 GAIF MCHSP Kl<-r NAIN7 ft ' pn * r-wpu ENC FAr1L n 0 ft , PIFp Rack*; 0 ll haffhol^fs n <' DEFT 33 n' DEM S4 DEM 0r n r. T C1 il 2 TL PATf '' TAUUH1 sups M/tilHN FAILS a9 tl 0 u0 ft 0 ft ft ft ft 00 un 1n ft ft ft n ft 0 11 0 11 0 ft 0 ft fl ft 0 00 ft i) ft 0 u0 10 ft 1 ft 0 ft ft u0 0 ft (1 0 ft A u0 fftt 0 ft 0n ft 0 ft 0 ft 0 00 0 ft 0ft ft 0 u0 J ft ft ft y ft ft tl fftt ti n ft A ft ft 1) 0 ft ft ft n ft 0 ft n ii ii MINOR INJURY AND ACCIDENT REPORT JANUARY i.4 accident type by scene or accident 7FKP FXTR (1 0 ft n 0 o 6 OPERATORS ONLY INHALA El EOT. CHEN lifting TION COPT CDNT ETC. 0 0 0 ft 0 n 0 ft 0 n 0 ft 0 p0 0 0 0 ft 0 0 a ft 0 0 00 0 N.E.C. e 0 0 0 0 6 0 ACC ACC . ACC,TO this ho last HO DATF n ft 0 00 0 0a 0 00 0 00 0 ft ft 0 00 0 0 ft ft 0 c 0 0 ft ft 0 n 0 00 i0 0 1 0 0000 0 n 0 ft 0 ft 6 0 0 n 0 0 ft 0 0 n 0 0 ft ftn 0 0 1 0 0 n 006 0 90 01 10 01 1 ft 00 0 ft 1 0 1 ft 0 0 0 0 ft 0 0 0 ft 0 ft ft ft ft 00 Q 0 (1 0 ft ft ft ft n 0 0 0 ft 0 ft 0 00 ft 0 0 0 ft 0 0 0 0 00000 00 00 0 6 ft 0 0 0 0 0 0 e ft 0 0 0 0 e0000 ft d 0 o ft 0 0 ft e 0 0 o 11 36 ft 0 00 o0 1 3 0 0 0 0 & 0 0 ft 0 00 Q 0 0 0 0 ft 0 e 00000 ft0 a 0 a 0 0 a a ft 00 ft 0 ft 0 ft ft 0 0 ft 0 ft 0 0 o ft 0 0 0 0 0 ft 0 0 ft 0 ft 00 ft 0 00 00 f 0 00 0 ft 0 0 0 0 0 0 ft ft 0 0 0 ft 0 0 0 Qa000 ft0 0 ft 0 0 0 0n080 ft ft ft ft 0 0 fftt 0 0 ft 0 0 0 n 0 ft 0 0 0 ft ft 0 0 ft 0 0 ft ft 0 n a 0000 c a ft 0 0 0 0 080n0 ftc 0 0 0 0 0 0 0000 ft 0 ft 1 0 0 00 00 ft 0 ft 0 00 00 0Q 00 10 4 0 c ft 0 0 0 0 1 n 0 (1 8 ft 8 0 0 ft 0 ft 0 0 ft ft 0 0 0 n 00006 0 ft 0 ft ft ft Q ft ft 0 0 0 a a ft 2 ft 0 ft 4 ft 2 0 0 00 00 00 00 00 ft 1 ft 10 00 9 ft 0 Q 0 0 8 0 CBV 101.6220 RSV0032561 71SASB DO Iff Wtm Dl SPACE CC 72, 73, 74 now tePAnmm ACCIDENT AMD INJURY REPORT MONSANTO COMPANY TEXAS Cm, TEXAS ** WBHB AID mOD 10 TBS BAFZFY DIRECTOR WITHOUT DELAY Am DiaSVSAitt TRSAgMEMT l- Lf f s 7- Tim -10 ~S---- Overtlac ^ Kic' if---------------nsr Of Accident Of Aeeldant I Mala . 1 Ye* Injured Person 2 Psaale 2 Me ^ Bld|c So. Dmr of Week ""T9------------- 1 Nos. 2 Tee*. 3 Ned. A. Ttaure. 5 Fri. 6 Sat* 7 Sun. Supervisor BTtOYBB SIAJBOff AS TO CAUSE OP INJURY 1 Ulcer 3 Driiile 01 Dept. I 02 Dept 2 03 Dept. 3 05 Dept. 5 07 Dept. ? C6 Dept 6 09 Dept. 10 10 Dept. 11 U Dept. 6 12 Dept 17 A lflC 13 Dept. Ifl-P CC 78-79 03 Analyst 30 Aabestos Waiter 31 Boilerunker 33 Carpenter 54 Electrician 10 Guard 63 Inst. Han <1 Bail HEffTOER l Circle One } 6 Tog, Suoke, cr base 3 Dry Norther Soov or Sleet 8 Hurricane 14 Dept. 19 SC9IE OP ACCUofr 15 Dept 20 IT Dept. 22 29 Control Lab 30 P. E. L*b 6n*-l 19 Dept. 24 20 Dept. 23 21 Dept. 26 22 Dept. 31 23 Dept. 41 24 Dept. 42 23 Dept. 43 26 Mein Ofrice 27 Office Annex 32 Shops 33 Xnatr. Shop 4 Docks 35 Truek Backs 36 Tank Car Reeks 37 Power 1 38 Power 2 39 Power 3 40 Otlliti**~0ther 0COT.no* Itlrcl* 6ae I----------- 4l Salvage 4s Streets 43 Tarda and Malta 44 North BO 43 North 68 46 locker Bldg*. 47 Bup,k Guard Offices 48 Klse. Mslet. Anas 49 Pilot Plant A HPU 30 Eag. Facilities 31 Pipe Racks 52 Warehouses 53 Dept, 33 5 Dept. 34 55 Dept. 35 52 Ironworker 30 Janitor SO Laborer 00 Oper. 64 Oper. Bagr. 33 Painter 38 Pipefitter 04 hapor Gauger 37 Sheet Natal 62 Trucker Stores Clark 71 Ingr. Aide 79 lab. Tech. 81 Mos-aseimt-Otbai 89 ClarlsaL- 91-Exsqpt-Tneh. Sere. 92 Eaagpt-Malnt 93 Exe^pt-Eagr. 94 Exenpt-OpentUg 93 Bxeapt-Other 99 Ixsspt-Res. rHEATMQrr and cocmeht Treated By [CC 51-33, 54-56 BjSSrfJRF" JTYPE OF tRJURY _ (circle One or Two) * CC 57-58 (Circle r * 100 Skull ' 110 Scalp * 120 Pace ' 13-- Ear* * lk_Eye* * 200 Neck *Por These Pasts, Indicate: MU^t, >Lsfft or > Both 50--Uppsr Arn* 3UIbow* fed Thigh* 6^jlnee* CL Lsceratloo * 02 locised Wound * 03 Puncture 04 Asgutatioo 06 Abrasion 07 Sprain 11 FractureH. 12 Contusions 13 Bum 14 Irritation 17 Inhalation of fuses 18 Internal ' 210 Nose A Throat 32_|swr Ara* * 30--Shoulders* 53--feint* * 310 Back 54--lbnd* 62,..Leg* 63--Ankle* 64__ Foot* 08 Strain 19 H.A.I 09 Dislocation 20 Blister * 10 Fracture Staple * 400 Abdosan 41__ Inguinal* 420 Raetum 3UM* 56--Jhd Finger* 57 W Plngnr* 58_>tb Finger* 65__ Great Toe* * 66--Any Other Toe* CC 59 Multiple 1 1 Minor 79--Upper body* 4 Ifejor SEVERITY (Circle One) 2 Dr. Case 3 Petal 5 Serious i* 430 Genitalis 130 Tth 59_Stt> Finger4 71--lower Body* 6 Non-Iiduntrlal Cby 1018221 RSV0032562 CC 61-64 0000 Agit*tor,KiKer 0400 Conveyor 0017 Drill 0009 Extruder 0009 Fio-tf Polisher 0018 istbe 1510 Boiler* 0^23 ColUHD* 0521 Exhengers 09A0 Dtt*ri*s 0120 Conductor* *3*1 Compressors 1225 Fire i;Js tetal Plate # 1010 Axe Oil niovtwrch 12 flroon,Brush /13 rtilsel Punch 1014 Dlei U raps I'/15 Drill Hud) 1053 Drill Pow*r) 1014 Tile AGENCIES (circle sly One) m object; SUBSTANCE OR EXPOSUR^'HOStTC106BLT ASSOCIATED WITH THE WJURT MACHINES 0013 Kill 00^3 Mower 0021 Packaging Mach OC&3 Picture ProJ. OC66 pile Driver 0094 Pipe Threader 0026 Planer, Shaper Jointer 0029 Presses OO38 Rolls OO9O Sandblast Mach. 0004 Sander, Grinder STEAM,V01IRS mad PRESSURE VESSELS 1931 filter* 00?4 Fwrnnce 0530 Boer 0525 PlPtog OJzB Tanks 0529 Trap ELECTRICAL APPARATUS 0902 Generators C90I Hotors <960 Rest,tog Appl. 0930 Switch Gear PIBCS AlfD PRIME MOVERS OHO Eng*& Prime Movers 0124 pen* A Blower* 0044 Becksaw (power) 0042 Saw (Table) 0048 Shears A Dicer 0007 Valve Grinder Machine 0012 Welding Machine OSQO Transformers >0120 Pumps 1121 Acid 1157 Additives 1132 Anvnonla 1128 AN 1134 Benzene 1122 Carbon Monoxide 113b CCU llb8 Catalyst CHEMICALS, DUST and RADIATION 1133 Caustic 1123 Chlorine 1159 dm 1300 Dust ljb2 EB 1153 EDC 1110 ExpLoslve Oases 1124 KCH 1129 Hexane 1131 Line 1125 Methanol 1126 Mercury 1155 Nitrogen 1137 Oils 1138 Polymer 1235 Paint, Varnish 1400 Rsdiat Lon 1327 Refrigerants n^6 Solvents Ubl Styrene 1140 Sulphur 1153 VAM 1154 VCH 1160 Unknown 061 4 Belts C6l2 Chain 0310 Creme WCBARICAL POWER TRARSMI&SlOfl 0004 Couplings C807 Caere C6l0 Drum*____________________S$9^S^*n_____ ElYAT0R& aad^BOlSTlRO APPARATUS 0200 Elevators 0330 Boists C8ll Ropes, Cables O32O Shovel 1530 Floors 1578 Roads WORKING SURFACE 1576 Roofs 1583 SidemIks 1582 Stairs, Ranips PLAMtABLE and NOT SUBSTANCES 1255 Steam 195^ Water HARD TOOLS 1017 Gleascatter 1051 Grinder 1023 Plpecutter 1028 Plans IMS Rurner, H.tdwt 1027 Pliers 1059 Bydrobleeter 1020 Jack IO56 Pneunmtic Tfmmrr 1062 Pmqp 1021 Knife IO65 Sandblaster 102$ Oilcan 1033 sandpaper 1026 Pick,Fork,Fickexe 1030 i*v(bwd) JO19 Pry Bar,Cheater 1993 Welding Rod or Slag 1066 Saw (Power) IO69 Screwdriver 1032 Shovel,Spade 1031 Sickle 1029 Tapeline 1070 Torch IO35 Ureneb 0650 Aircraft 0640 Barges/Ships 0$60 Bicycles 0611 fork-lift 0691 Band trucks. Tool Bo* * Wheelbarrow* 0610 Motor Vehicle 0630 Railway MISCgUAJfZOlC * 1916 Bags, Boxes 1934 Slumn * 191* Barrels, Drums 1979 Bandrsils 1915 Bottles (ICC) 0730 Insects A Snakes 1918 Cans 1947 Kitehen Equipment 1 1923 Ditches,Treocbe* 1952 lab. Equip. Hisc. ' 1922 Doors ,Windent* 1950 ladders r 193O Floor Openings 1932 Food 1951 Toedlag Platforms 1954 Manholes 1978 Scaffold 1950 Rails i960 Qpliater,Sliver 1937 Nuts,Bolts 1981 Structure or Brace 1963 Office Equipt. 1991 Wire-bon-Flect. A Machines 1992 Workbench,!)*** 1966 Person 1967 Ptpefittings A Valves * 1999 Hisc. Matl. or Obj . Please Specify 8 S -8 8 3 S 5 ? Accipprr mi: (Circle One) CCG5-66 00 Striking Against 01 Struck 2y OP '-wight n or Between i U--Sum level *11--Dlfferent Level Clip Temperature Extreme Into IrtlOB,Ingestion electrical Contact Cnenical Contact Lifting,Pushing,Pulling H.I.C. MBWE MECHANICAL OR PklSICAL XWDITION CC67 (Circle One) 0 Ii^roperly Guarded 1 Defect of Agency 2 Rousekeeping 3 logiroper Illmnatioe A Improper Vantiiatico 3 Defective Apparel 6 1i^iroper Deeigp 9 (Please SpecifyV~ UNSAFE ACT CC 6&-69 (Circle One) 00 Operating Without Authority 01 Using Unsafe Speed 02 Making Safety Devices Inoperative 03 Using Unsafe Equipment or Using Unsafely 04 Unsafe Loadii^,Pi ling,Mixing 03 Unsafe Posture or Position 06 Working on Moving Eqalpsant 07 Borsapl*yvete 08 failure te Use Protective Equipment or clothing 09-------(PllM Spe'ilfrJ-------- 10 improper Method H failure to Be Ueraml UNSAFE PUeOMAL FACTOR CC70 (Circle One) 0 Improper Attitude TJoyou feel that excessive overtime contributed to thla accident9 If "Yea", plcaae cownent below, 3 Ye3 1 lack of Knowledge or Skill CORRECTIVE ACTION TAKES TO PREVENT BBCURREBcS 2 Bodily Defects 3 Lack of Instruction* 4 Inattention-Injured 5 Wilful Disregard of Safety Bole or Instruction* 6 Inexperience 7 dnattastlon-Felimi Worker 9____ , (Please Specify) 4 No (Supervisor's aigpacureP CBY 1018222 RSV0032563 L0 I 0CN ccJ INJ PTS AS GE NV date D Ac AP WS D A 0 CN CELEE P TIME Y T C D T R R T X T 9 3n 12 120000 1947 2 1/21/66 1010 5 2 0 9 9 2 4 2 1 811 9 56 6 612000 110 1 1/24/66 930 1 2 0 9 5 4 3 2 1 811 9 J 12 5*2000 1922 2 1/29/66 1630 6 2 2 0 9 9 4 9 1 10 11 5 3 12 611000 1978 1 1/ 6/66 915 4 2 1 9 10 4 4 1 1 811 12 0 6 120132 1582 1 1/16/66 610 7 2 0 9 1 4 4 1 1 17 12 60 12 562592 1914 2 1/24/66 900 1 2 2 9 5 4 3 2 1 811 12 92 14 ninoo 1160 2 1/20/66 1430 4 2 9 9 5 9 4 6 1 811 12 56 13 542ooo 1956 1 1/ 3/66 1100 1 2 6 0 11 9 4 6 1 811 14 C 13 i20210 11 21 1 1/22/66 1340 6 2 9 9 10 1 4 6 1 19 1/ 51 6 120000 1957 1 1/21/66 900 5 2 1 9 5 4 4 2 1 811 17 5l 1 561000 1018 1 1/24/66 1300 1 2 1 1 3 4 4 2 1 811 18 56 12 631000 1957 2 1/27/66 1610 4 2 0 9 5 9 3 2 1 811 22 50 1 542000 1980 1 1/28/66 1600 5 2 0 1 10 4 3 2 1 811 22 53 1 120150 1581 5 1/12/66 1035 3 2 0 1 10 4 4 1 1 811 23 0 12 551000 1967 1 1/14/66 1345 5 2 2 9 9 9 4 6 1 41 24 C 1 551000 1967 1 1/ 9/66 2400 7 2 0 6 9 9 4 1 1 42 24 0 1 110000 1019 2 1/18/66 1400 2 2 1 6 9 4 4 3 1 42 ?4 55 8 310000 1530 5 1/11/66 930 2 2 5 2 9 9 3 1 1 712 24 0 12 521542 1530 2 1/31/66 900 1 2 3 2 1 4 4 6 1 42 28 99 14 141000 1156 1 1/21/66 820 5 2 9 9 3 4 4 2 1 750 28 79 6 561000 1914 1 1/25/66 910 2 2 2 2 4 4 4 6 1 750 28 30 1 120000 1922 1 1/13/66 2215 4 2 1 9 9 9 4 2 1 750 32 56 1 572000 18 5 1/21/66 530 5 2 1 9 6 4 4 6 1 811 32 56 12 552000 1018 1 1/26/66 1730 3 2 1 9 2 9 3 1 1 811 32 51 10 581000 811 5 1/28/66 1515 5 2 2 9 10 7 4 3 1 811 32 53 1 582000 1980 1 1/ 4/66 1515 2 2 0 1 9 4 4 2 1 811 32 60 1 562000 1934 1 1/10/66 1420 1 2 0 1 11 4 4 6 1 811 32 56 14 142000 1160 2 1/11/66 1900 2 2 1 9 9 9 4 1 1 811 32 56 5 551000 1051 1 1/12/66 8(j5 3 2 0 9 1 9 4 6 1 811 CBY 1018223 RSV0032564 (. I L0 I 0C N ccJ IN J PTS AS GE NV DATE D AC AP WS D A0 CN CELEE P TIME Y T c D T R R T X T 32 58 8 3 100 00 1967 1 1/14/66 1000 5 2 10 9 5 9 4 3 1 811 34 4 12 541000 1035 2 12/31/65 1900 5 2 0 1 3 4 4 1 1 412 35 58 12 5120 0 0 1035 5 1/27/66 1430 4 2 1 9 10 9 4 1 1 811 36 4 8 310000 63o 2 1/17/66 2345 1 2 10 9 5 0 4 1 1 412 36 58 8 411000 1035 1 1/ 7/66 1030 5 2 10 9 5 9 4 1 1 811 37 53 1 542000 1978 1 1/14/66 1425 5 2 2 9 5 4 4 6 1 811 38 71 13 542000 1967 1 1/21/66 1525 5 2 6 9 9 4 4 2 1 712 38 55 14 141000 1300 2 1/25/66 1600 2 2 1 9 9 9 3 3 1 712 42 58 7 301531 1583 5 1/19/66 1235 3 2 3 2 9 9 4 2 1 811 42 62 12 400000 1914 2 1/11/66 1245 2 2 1 9 10 4 4 1 1 811 48 58 6 541000 1957 1 1/17/66 900 1 2 0 9 3 4 4 6 1 811 48 55 1 120000 1922 1 1/19/65 1400 3 2 0 9 5 4 4 2 1 712 48 62 8 310000 521 5 1/24/66 900 1 2 10 9 10 4 4 2 1 811 48 55 6 571581 1918 1 1/27/66 1120 4 2 1 1 9 4 4 9 1 712 49 58 14 120143 1121 2 1/31/66 415 1 1 9 6 9 9 4 1 1 811 49 58 14 120143 1121 2 1/31/66 415 1 1 9 6 9 9 4 1 1 811 49 0 14 143000 1121 2 1/31/66 415 1 2 9 6 9 9 4 1 1 750 53 56 14 142000 1160 2 1/ 8/66 1015 6 1 1 9 9 9 4 1 1 811 54 58 13 120000 1255 1 1/21/66 1540 5 2 6 0 5 4 4 2 1 811 CBV 1018224 RSV0032565