| Report Date | December 4, 2020 |
|---|---|
| Injury Time | 12:00 PM |
| State | WV |
| Injury Date | 12/03/2020 |
| Longitude | -80.143021 |
| Well Lease | Lemley |
| Pad | Lemley |
| Country | United States |
| Latitude | 39.666620 |
| Township/City | Fairview |
| 911 Address | Lemley Well Site |
| Weather | Sunny |
| Well Number | 7H |
| Well Field | Blacksville |
| Position | Traffic Control |
| Company | GMS |
| Personnel/Witness Name | James Grant |
| Days Into Hitch | 4 |
| Years With Company | 4 |
| Years In Oil/Gas | 4 |
| Personnel/Wittness Phone | (941) 771-5390 |
| Witness Name | n/a n/a |
| Time Lost | no time lost |
| Task | James was checking in personnel and administering temp check and COVID questionnaire for Lemley top hole from a guard shack positioned off location on the access road. |
| Summary | While leaving the shack to check in a vehicle, a weld on the steps broke causing James to fall on his right hip. He notified his supervisor and refused medical attention. He was able to finish his shift and seems to be okay. The shack is not set on level ground and had been cribbed with boards to support and level the shack. |
| Witness Statement | n/a |
| Drug Test | Drug test was taken by GMS |
| Injury Location | Right Hip Bruise |
| Treatment | self administered first aid |
| Proper PPE | Proper PPE was in use at time of incident |
| Contributing Factors | Proper cribbing and support for stairs and shack. |
| Notification Timeline | Immediate Notification |
| Corrective Action | Placed additional support under stairs with jacks |
| Supervisor Phone | (304) 216-7707 |
| Supervisor Email | Email hidden; Javascript is required. |
| Supervisor Name | jeff weimer |
| HSE Name | Jeff Weimer |
| Supervisor Office Phone | (304) 216-7707 |
| HSE Phone | (304) 216-7707 |
| HSE Office Phone | (304) 216-7707 |
| Comp. Man Name | Andy Travis |
| Comp. Man Email | Email hidden; Javascript is required. |
| HSE Email | Email hidden; Javascript is required. |
| Comp. Man Office Phone | (304) 212-0415 |
| Comp. Man Phone | (304) 212-0415 |
| NNE Name | Andy Travis |
| NNE Email | Email hidden; Javascript is required. |
| NNE Phone | (304) 212-0415 |
| NNE Office Phone | (304) 212-0415 |
| NNE HSE Name | Andy Travis |
| NNE HSE Office Phone | (304) 212-0415 |
| NNE HSE Email | Email hidden; Javascript is required. |
| NNE HSE Number | (304) 951-0909 |
| Employee That Submitted Report | Andy Travis |
| Date Updated | March 18, 2021 |
| Approval Status | Unapproved |
| Employee's Other Reports |
