| Report Date | April 16, 2020 |
|---|---|
| Injury Time | 03:00 PM |
| State | WV |
| Injury Date | 04/15/2020 |
| Longitude | 80° 16' 19.02"W |
| Well Lease | McClellan |
| Pad | McClellan |
| Country | United States |
| Latitude | 39° 36' 54.21"N |
| Township/City | Fairview |
| 911 Address | 321 Harvey Run Rd. Fairview, WV 26570 |
| Weather | Cooler, windy, sunny. |
| Well Number | N/A |
| Well Field | Battelle |
| Position | Laborer |
| Company | Apex |
| Personnel/Witness Name | Cornelius Johnson |
| Days Into Hitch | 1 |
| Years With Company | 0.9 |
| Years In Oil/Gas | 1 |
| Personnel/Wittness Phone | (304) 551-6708 |
| Witness Name | Cornelius Johnson |
| Time Lost | No |
| Task | Attaching camlock hose fitting together to lengthen suction hose. |
| Summary | While putting together two hoses a burr went through Cornelius's glove and cut his left ring finger. General first aid requiring antiseptic cream and a band aid was administered. No further action was required. |
| Witness Statement | Was putting together two hoses and felt something scrape his finger through his glove. Took gloves off to see what had happened and saw his finger was cut. Immediately notified supervision. |
| Drug Test | No |
| Injury Location | Hand |
| Treatment | First Aid, band aid |
| Proper PPE | Yes, gloves |
| Contributing Factors | Initial inspection of equipment |
| Notification Timeline | Immediately |
| Corrective Action | Burr was removed with wire cutters |
| Supervisor Phone | (724) 809-6025 |
| Supervisor Email | Email hidden; Javascript is required. |
| Supervisor Name | Bryan Hall |
| HSE Name | Bryan Hall |
| Supervisor Office Phone | (724) 809-6025 |
| HSE Phone | (724) 809-6025 |
| HSE Office Phone | (724) 809-6025 |
| Comp. Man Name | Josh Grim |
| Comp. Man Email | Email hidden; Javascript is required. |
| HSE Email | Email hidden; Javascript is required. |
| Comp. Man Office Phone | (304) 276-3899 |
| Comp. Man Phone | (304) 276-3899 |
| NNE Name | Josh Dalton |
| NNE Email | Email hidden; Javascript is required. |
| NNE Phone | (724) 825-6859 |
| NNE Office Phone | (724) 825-6859 |
| 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 | Josh Dalton |
| Date Updated | March 18, 2021 |
| Approval Status | Unapproved |
| Employee's Other Reports |
