MINE SAFETY AND HEALTH ADMINISTRATION
Metal and Nonmetal Mine Safety and Health
Accident Investigation Report
Surface Nonmetal Mine
Fatal Handling Material Accident
Murray's Contracting Company
ID No. 1QA
Keystone Cement Company
Keystone Cement Company (Mine)
Bath, Northampton County, Pennsylvania
I.D. No. 36-00125
January 27, 1999
Dennis A. Yesko
Supervisory Mine Safety and Health Inspector
Charles J. Weber
Mine Safety and Health Inspector
John W. Fredland Jr.
Supervisory Civil Engineer
Darren J. Blank
Mine Safety and Health Administration
230 Executive Drive, Suite 2
Cranberry Township, Pennsylvania 16066-6415
James R. Petrie
Julius Vance Murray, age 51, company co-owner, was fatally injured at about 11:30 a.m., on January 27, 1999, when he was engulfed by material while working inside a cement silo. Murray had a total of nine years mining experience, which included about five years cleaning silos on a part-time basis. He had not received training in accordance with 30 CFR, Part 48.
MSHA was notified at 12:15 p.m. on the day of the accident by a telephone call from the plant manager for the mining company. An investigation was started the same day.
The Keystone Cement Co. mine, a surface quarry and cement plant, owned and operated by Keystone Cement Co., a subsidiary of Giant Cement Holding, Inc., was located at Bath, Northampton County, Pennsylvania. The principal operating official was Stephen J. Hayden, Jr., plant manager. The plant was normally operated three, 8-hour shifts a day, seven days a week. A total of 120 persons was employed.
Limestone was drilled and blasted from multiple benches in the pit and transported by truck to the primary crusher. Crushed material was transported by conveyor belt to the mill for further sizing and processing into Portland Cement. The finished product was either bagged or stored in silos for bulk shipment.
Murray's Contracting Co. was an independent contractor located at Saylorsburg, Monroe County, Pennsylvania. The principal operating officials were Bonita Murray, owner and president, and Vance Murray, co-owner. This contractor had been enlisted to clean several silos at the cement plant.
The last regular inspection of this operation was completed on November 25, 1998.
PHYSICAL FACTORS INVOLVED
The accident occurred at the No. 24 transfer silo, which was one of a group of ten silos used to store finished cement. It measured approximately 80 feet high by 30 feet in diameter, and was constructed of reinforced concrete. A tunnel underneath the silo was constructed with eight openings, four on each side, to allow cement to discharge into a screw conveyor. The bottom of the silo was sloped at an angle of approximately 40 degrees toward the tunnel openings. An access door, measuring 16-inches high by 18-inches wide, was located on the side of the silo. The door was located approximately 15 feet above the bottom of the silo, and was accessible from the roof of a pump house. Inside the silo, the access door was approximately 8 feet above the top of the tunnel.
The transfer silos were typically cleaned once a year to remove cement that builds up on the silo walls. Reportedly, cement tended to adhere to the silos' walls and harden because of leaks in the roofs. The silos were cleaned using a two-phase process. Phase one was completed by Martin Services, another contractor, who removed material adhering to the walls by a mechanical process involving a "bin whip." The "bin whip" device was attached to a telescoping boom and lowered into the silo through an 8-inch diameter hole in the roof. The device worked through a combination of high pressure air and spinning action, similar to a weed wacker. Loosened material fell to the bottom of the silo as powder or in the form of chunks.
The second phase of the cleaning process involved removing material that was loosened in the first phase, and removing any caked material from the top and sides of the tunnel. This was done primarily by prodding the material through the openings in the bottom of the silo, or by striking the walls of the tunnel with a sledge hammer. After as much material as possible was removed by this process, the silo would be entered via the access door to remove material from atop the tunnel and to knock down any remaining material.
The silo was normally entered by hanging an 8.7-foot long ladder from the access door, and then positioning a plank from a rung near the bottom of the ladder to the top of the tunnel. Workers would then bar down the material from atop the tunnel. On occasion, when material hung up and could not be removed in this manner, explosives were used to dislodge the cement.
The No. 24 silo was the last to be cleaned by Martin Services. They found that this silo had a heavier build-up of cement on its sides than the others. Consequently, they were unable to clean this silo as deep as the rest, and had stopped approximately 14 feet above the access door. Loosened material that had fallen to the bottom of the silo was not drawn out during the phase-one cleaning process.
Following the accident, cement was found to be caked on the walls of the silo to a thickness of over 2 feet, and was banked along the walls of the silo to a height of about 14 feet above the access door. Some of the caked material was found to be soft and easily dislodged, while other material had set up, or at least developed a hard crust, and could not be dislodged using a prodding tool. The mine operator reported that the normal practice had been not to enter the silo until the caked material was scaled down to the level of the top of the tunnel. The cement that fell and engulfed Murray came from above the access door area. Support for this material was weakened when the material that had been caked against the inside of the access door was removed.
The weather at the time of the accident was partly cloudy and the temperature was about 35 to 40 degrees Fahrenheit.
DESCRIPTION OF THE ACCIDENT
On the day of the accident, Vance Murray (victim) reported for work at 7:00 a.m., his normal starting time. Murray instructed his crew of three employees, Charles Sebella, Robert Sebella, and James Cole, to continue cleaning the No. 24 silo. Work progressed without incident until about 9:20 a.m., when no more material could be withdrawn through the tunnel opening closest to the access door. They decided to open the access door to gain entry to the silo in order to free the hung up material. When the door was opened, the cement that was packed in front of the door was knocked away creating an opening into the silo. Charles Sebella discussed entering the silo with Murray. Murray looked at conditions inside the silo, and told him that it was unsafe and that no one was to enter.
Following a coffee break at about 9:30 a.m., the crew resumed work. Cole and Robert Sebella worked in the tunnel below the silo, poking rods and air lances into the draw openings to get the material to flow. Charles Sebella was working outside the access door, pushing material down to the feed holes with a chipping hoe. At this time, Murray approached and started to enter the silo. Charles Sebella asked Murray why he was doing this after he had told them it was unsafe. Murray did not respond and went through the door into the silo. He was not wearing a safety belt and line and there was no staging or platforms to work from. Once inside, Murray began scaling material from the walls.
At about 11:15 a.m., Charles Sebella saw Murray standing on a ledge of material near the access door opening. As Murray worked to dislodge cement from above the door, a large amount of material fell from the wall. Murray was knocked down into the feed area of the silo and buried.
Charles Sebella immediately notified others and summoned help. George Gasper, Keystone shipping supervisor, and Robert Sebella, entered the silo and uncovered Murray to his waist. Murray was not responsive. Their efforts were hindered by constantly falling material. An emergency rescue squad arrived and took over recovery efforts. Rescue efforts from within the silo were discontinued due to the danger of falling material. Attempts at recovery continued from outside the silo, and a county medical examiner pronounced Murray dead at about 6:30 p.m. A large opening was eventually cut into the side of the silo and his body was recovered at about 8:00 p.m.
The primary cause of the accident was entering the silo when there was danger falling material. Failure to wear a safety belt and line, and failure to shut off the flow of material through the draw hole in the bottom of the silo before working inside, contributed to the severity of the accident.
Order No. 7718837 was issued on January 27, 1999, under the provisions of Section 103(k) of the Mine Act:
A fatal accident occurred at this operation on January 27, 1999, when a contractor employee was buried under material while working in the transfer storage silos. This order is issued to assure the safety of persons at this operation and prohibits any work other than rescue procedures in this area in order to assure the safety of all persons as determined by an Authorized Representative of the Secretary of Labor. The mine operator shall obtain approval from an authorized representative for all actions to recover, and/or restore operations in the affected area.Murray's Contracting Company:
Citation No. 4439700 was issued on February 10, 1999, under the provisions of section 104(a) of the Mine Act for violation of 30 CFR 56.16002(c):
The co-owner of a contracting company was fatally injured at this operation on January 27, 1999, when he was engulfed by a fall of material while working inside a silo. Just prior to the accident, he had instructed an employee that it was unsafe to work inside the silo and that no one was to enter it. A short time later, he entered the silo and began cleaning material from the sides. A platform or staging was not provided. Further, a safety belt and line were not worn. The discharge screw in the tunnel underneath the silo had not been deenergized and locked out.The compliance date for this citation is February 17, 1999.
Citation No. 4434321 was issued on February 10, 1999, under the provisions of section 104(a) of the Mine Act for violation of 30 CFR 56.18002(c):
The co-owner of a contracting company was fatally injured at this operation on January 27, 1999, when he was engulfed by a fall of material while working inside a silo. While he looked inside the silo and instructed an employee that it was unsafe to work inside, he entered the silo himself a short time later.The compliance date for this citation is February 17, 1999.
Keystone Cement Company:
Citation No. 4439698 was issued on February 9, 1999, under the provisions of section 104(d)(1) of the Mine Act for violation of 30 CFR 56.16002(a)(1):
A contractor was fatally injured at this operation on January 27, 1999, when he was engulfed by a fall of material while working inside a silo. The mine operator failed to fully utilize mechanical devices or other effective means of cleaning this silo so that persons would not be required to enter or work where they were exposed to entrapment by the caving or sliding of materials. Failure to equip the silo with a mechanical device or other effective means is a serious lack of reasonable care which constitutes more than ordinary negligence and is an unwarrantable failure to comply with a mandatory safety standard.The compliance date for this citation is February 16, 1999.
Order No. 4439699 was issued on February 9, 1999, under the provisions of section 104(d)(1) of the Mine Act for violation of 30 CFR 56.18002(a):
A contractor was fatally injured at this operation on January 27, 1999, when he was engulfed by a fall of material while working inside a silo. The mine operator knew the contractor had to enter the silo to remove material and failed to examine the work place for conditions which could adversely affect safety or health. Further, ladders, platforms or staging were not provided to work from. Failure to provide these devices is a serious lack of reasonable care constituting more than ordinary negligence and is an unwarrantable failure to comply with a mandatory safety standard.The compliance date for this citation is February 16, 1999.
A. Persons Participating in the Investigation
B. Plan and Profile Views of Silo 24
Persons Participating in the Investigation
Keystone Cement Company
John Groover, director, human resourcesPaper, Atomic, Chemical Engineers International Union
Rocco Marinaro, environmental compliance manager
David Reppert, safety director
Steven J. Hayden Jr., plant manager
Dennis Liberto, union president/miner's representativeEast Allen Township Fire Department
Ronald Check, fire chiefMine Safety and Health Administration
Dennis Yesko, supervisory mine safety and health inspector.
Charles J. Weber, mine safety and health inspector/special investigator
Robert Carter, mine safety and health inspector
John W. Fredland Jr., supervisory civil engineer, Pittsburgh Safety and Health Technology Center
Darren J. Blank, civil engineer, Pittsburgh Safety and Health Technology Center
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