ADJUSTABLE FORMS INC
836 WELLINGTON, Chicago, IL 60657
Having inspection records is common for businesses in regulated industries. Data and methodology
Inspection records
Feb 20, 2009#312593080Feb 20, 2009Programmed Related (I) · Partial scope, Safety#312593080$01 viol.1 violation$0 in penalties
Inspection #312593080
Dates
- Opened
- Feb 20, 2009
- Closing Conference Date
- Feb 20, 2009
- Closed
- Apr 2, 2009
Inspection
- Advance Notice
- No
- Owner Type
- Private
- Union Status
- Yes
- Number of Employees
- 20
Violations and Penalties
- Total Violations
- 1
- Violation Types
- 1 other-than-serious
- Initial Penalties
- $800
- Penalties on Record
- $0
- Site Address
- 235 West Van Buren, Chicago, IL 60607
- Industry
- 238110 Poured Concrete Foundation and Structure Contractors
Programmed Related Inspection: This inspection record is categorized as a programmed related inspection in the DOL OSHA enforcement data. The public DOL category label is preserved here without adding extra interpretation beyond the government label.
Violations
Violation list (1 of 1 shown)
| Citation | Standard | Type | Instances | Exposed | Initial | Current | Abatement | Contest | Final Order |
|---|---|---|---|---|---|---|---|---|---|
| 01001 | 1926.502 Fall Protection Systems Criteria and Practices OSHA citation code: 19260502 B06 | Other | 10 | 3 | $800 | $0 | Mar 20, 2009 | - | - |
Jan 28, 2009#312592348Jan 28, 2009Unprogrammed Related (G) · Partial scope, Safety#312592348$5001 viol.1 violation$500 in penalties
Inspection #312592348
Dates
- Opened
- Jan 28, 2009
- Closing Conference Date
- Jan 28, 2009
- Contested
- May 15, 2009
- Final Order
- Nov 27, 2009
- Closed
- Dec 1, 2009
Inspection
- Advance Notice
- No
- Owner Type
- Private
- Union Status
- Yes
- Number of Employees
- 25
- Related Activity
- 1 referral
Violations and Penalties
- Total Violations
- 1
- Violation Types
- 1 serious
- Initial Penalties
- $4,000
- Penalties on Record
- $500
- Site Address
- 10 E. Delaware Place, Chicago, IL 60611
- Industry
- 238110 Poured Concrete Foundation and Structure Contractors
Unprogrammed Related Inspection: This inspection record is categorized as an unprogrammed related inspection in the DOL OSHA enforcement data. The public DOL category label is preserved here without adding extra interpretation beyond the government label.
Violations
Violation list (1 of 1 shown)
| Citation | Standard | Type | Instances | Exposed | Initial | Current | Abatement | Contest | Final Order |
|---|---|---|---|---|---|---|---|---|---|
| 01001 | 1926.451 Scaffolding - General Requirements OSHA citation code: 19260451 A01 | Serious | 1 | 1 | $4,000 | $500 | Apr 28, 2009 | May 15, 2009 | Nov 27, 2009 |
May 28, 2008#311374714May 28, 2008Complaint (B) · Complete scope, Safety#311374714$00 viol.0 violations$0 in penalties
Inspection #311374714
Dates
- Opened
- May 28, 2008
- Closing Conference Date
- May 28, 2008
- Closed
- May 28, 2008
Inspection
- Advance Notice
- No
- Owner Type
- Private
- Union Status
- Yes
- Number of Employees
- 20
- Related Activity
- 1 complaint
Violations and Penalties
- Total Violations
- 0
- Initial Penalties
- $0
- Penalties on Record
- $0
- Site Address
- 235 W. Van Buren, Chicago, IL 60603
- Industry
- 238110 Poured Concrete Foundation and Structure Contractors
Complaint Inspection: This inspection record is categorized as a complaint inspection in the DOL OSHA enforcement data. OSHA can open complaint-driven inspections after receiving safety or health complaints from workers or their representatives.
Apr 22, 2008#311373633Apr 22, 2008Programmed Related (I) · Partial scope, Safety#311373633$1,2002 viol.2 violations$1,200 in penalties
Inspection #311373633
Dates
- Opened
- Apr 22, 2008
- Closing Conference Date
- May 6, 2008
- Closed
- Jun 23, 2008
Inspection
- Advance Notice
- No
- Owner Type
- Private
- Union Status
- Yes
- Number of Employees
- 14
Violations and Penalties
- Total Violations
- 2
- Violation Types
- 2 serious
- Initial Penalties
- $2,400
- Penalties on Record
- $1,200
- Site Address
- 2175 S. Michigan, Chicago, IL 60616
- Industry
- 238110 Poured Concrete Foundation and Structure Contractors
Programmed Related Inspection: This inspection record is categorized as a programmed related inspection in the DOL OSHA enforcement data. The public DOL category label is preserved here without adding extra interpretation beyond the government label.
Violations
Violation list (2 of 2 shown)
| Citation | Standard | Type | Instances | Exposed | Initial | Current | Abatement | Contest | Final Order |
|---|---|---|---|---|---|---|---|---|---|
| 01001 | 1910.1200 Hazard Communication OSHA citation code: 19101200 H | Serious | 14 | 2 | $1,200 | $600 | May 28, 2008 | - | - |
| 01002 | 1926.51 Sanitation (Construction) OSHA citation code: 19260051 F | Serious | 1 | 2 | $1,200 | $600 | May 28, 2008 | - | - |
Nov 21, 2007#311369821Nov 21, 2007FatalityAccident (A) · Partial scope, SafetyFatality#311369821$00 viol.0 violations$0 in penalties
Inspection #311369821
Dates
- Opened
- Nov 21, 2007
- Closing Conference Date
- Dec 18, 2007
- Closed
- Jan 3, 2008
Inspection
- Advance Notice
- No
- Owner Type
- Private
- Union Status
- Yes
- Number of Employees
- 50
- Related Activity
- 1 accident
Violations and Penalties
- Total Violations
- 0
- Initial Penalties
- $0
- Penalties on Record
- $0
- Site Address
- 111 W. Wacker Dr., Chicago, IL 60601
- Industry
- 238110 Poured Concrete Foundation and Structure Contractors
Accident Inspection: This inspection record is categorized as an accident inspection in the U.S. Department of Labor OSHA enforcement data. Employers must report work-related fatalities within 8 hours, and work-related inpatient hospitalizations, amputations, or losses of an eye within 24 hours. An accident-related inspection does not by itself determine fault.
Incident Investigation Summaries
Incident investigation summaries linked to this inspection through OSHA's accident and injury enforcement data. These summaries describe the reported incident. The enforcement outcome for the linked inspection is in the inspection details above.
Employee killed in fall down elevator shaft
Jul 3, 2007#310177936Jul 3, 2007Complaint (B) · Partial scope, Safety#310177936$76,0004 viol.4 violations$76,000 in penalties
Inspection #310177936
Dates
- Opened
- Jul 3, 2007
- Closing Conference Date
- Oct 17, 2007
- Closed
- Nov 27, 2007
Inspection
- Advance Notice
- No
- Owner Type
- Private
- Union Status
- Yes
- Number of Employees
- 50
- Related Activity
- 1 complaint
Violations and Penalties
- Total Violations
- 4
- Violation Types
- 3 serious, 1 willful
- Initial Penalties
- $91,000
- Penalties on Record
- $76,000
- Site Address
- 2 West Erie Street, Chicago, IL 60611
- Industry
- 238110 Poured Concrete Foundation and Structure Contractors
Complaint Inspection: This inspection record is categorized as a complaint inspection in the DOL OSHA enforcement data. OSHA can open complaint-driven inspections after receiving safety or health complaints from workers or their representatives.
Violations
Violation list (4 of 4 shown)
| Citation | Standard | Type | Instances | Exposed | Initial | Current | Abatement | Contest | Final Order |
|---|---|---|---|---|---|---|---|---|---|
| 01001 | 1926.451 Scaffolding - General Requirements OSHA citation code: 19260451 B01 | Serious | 1 | 3 | $7,000 | $7,000 | Oct 29, 2007 | - | - |
| 01002 | 1926.451 Scaffolding - General Requirements OSHA citation code: 19260451 G01 | Serious | 1 | 3 | $7,000 | $7,000 | Oct 29, 2007 | - | - |
| 01003 | 1926.501 Fall Protection - Duty to Have Fall Protection OSHA citation code: 19260501 B02 II | Serious | 1 | 3 | $7,000 | $7,000 | Oct 29, 2007 | - | - |
| 02001 | 1926.501 Fall Protection - Duty to Have Fall Protection OSHA citation code: 19260501 B02 I | Willful | 2 | 3 | $70,000 | $55,000 | Oct 29, 2007 | - | - |
May 16, 2007#310176789May 16, 2007Complaint (B) · Partial scope, Safety#310176789$4,0001 viol.1 violation$4,000 in penalties
Inspection #310176789
Dates
- Opened
- May 16, 2007
- Closing Conference Date
- May 16, 2007
- Closed
- Sep 5, 2007
Inspection
- Advance Notice
- No
- Owner Type
- Private
- Union Status
- Yes
- Number of Employees
- 70
- Related Activity
- 1 complaint
Violations and Penalties
- Total Violations
- 1
- Violation Types
- 1 serious
- Initial Penalties
- $7,000
- Penalties on Record
- $4,000
- Site Address
- 410 N. Dearborn St., Chicago, IL 60610
- Industry
- 238110 Poured Concrete Foundation and Structure Contractors
Complaint Inspection: This inspection record is categorized as a complaint inspection in the DOL OSHA enforcement data. OSHA can open complaint-driven inspections after receiving safety or health complaints from workers or their representatives.
Violations
Violation list (1 of 1 shown)
| Citation | Standard | Type | Instances | Exposed | Initial | Current | Abatement | Contest | Final Order |
|---|---|---|---|---|---|---|---|---|---|
| 01001 | 1926.703 Concrete and Masonry - Cast-in-Place Concrete OSHA citation code: 19260703 A01 | Serious | 1 | 70 | $7,000 | $4,000 | Jul 27, 2007 | - | - |
Mar 6, 2007#310174818Mar 6, 2007Programmed Related (I) · Partial scope, Safety#310174818$7,0001 viol.1 violation$7,000 in penalties
Inspection #310174818
Dates
- Opened
- Mar 6, 2007
- Closing Conference Date
- Mar 6, 2007
- Closed
- May 9, 2007
Inspection
- Advance Notice
- No
- Owner Type
- Private
- Union Status
- Yes
- Number of Employees
- 50
Violations and Penalties
- Total Violations
- 1
- Violation Types
- 1 repeat
- Initial Penalties
- $12,500
- Penalties on Record
- $7,000
- Site Address
- 410 N. Dearborn St., Chicago, IL 60610
- Industry
- 238110 Poured Concrete Foundation and Structure Contractors
Programmed Related Inspection: This inspection record is categorized as a programmed related inspection in the DOL OSHA enforcement data. The public DOL category label is preserved here without adding extra interpretation beyond the government label.
Violations
Violation list (1 of 1 shown)
| Citation | Standard | Type | Instances | Exposed | Initial | Current | Abatement | Contest | Final Order |
|---|---|---|---|---|---|---|---|---|---|
| 01001 | 1926.300 General Requirements - Tools, Hand and Power OSHA citation code: 19260300 B01 | Repeat | 2 | 2 | $12,500 | $7,000 | Apr 3, 2007 | - | - |
Jan 26, 2007#310177084Jan 26, 2007Programmed Related (I) · Partial scope, Safety#310177084$17,5001 viol.1 violation$17,500 in penalties
Inspection #310177084
Dates
- Opened
- Jan 26, 2007
- Closing Conference Date
- Apr 12, 2007
- Closed
- Jul 10, 2007
Inspection
- Advance Notice
- No
- Owner Type
- Private
- Union Status
- Yes
- Number of Employees
- 75
Violations and Penalties
- Total Violations
- 1
- Violation Types
- 1 repeat
- Initial Penalties
- $35,000
- Penalties on Record
- $17,500
- Site Address
- 1720 S. Michigan, Chicago, IL 60616
- Industry
- 238110 Poured Concrete Foundation and Structure Contractors
Programmed Related Inspection: This inspection record is categorized as a programmed related inspection in the DOL OSHA enforcement data. The public DOL category label is preserved here without adding extra interpretation beyond the government label.
Violations
Violation list (1 of 1 shown)
| Citation | Standard | Type | Instances | Exposed | Initial | Current | Abatement | Contest | Final Order |
|---|---|---|---|---|---|---|---|---|---|
| 01001 | 1926.501 Fall Protection - Duty to Have Fall Protection OSHA citation code: 19260501 B01 | Repeat | 1 | 3 | $35,000 | $17,500 | Jun 12, 2007 | - | - |
Dec 14, 2006#310172804Dec 14, 2006Referral (C) · Partial scope, Safety#310172804$00 viol.0 violations$0 in penalties
Inspection #310172804
Dates
- Opened
- Dec 14, 2006
- Closing Conference Date
- Dec 14, 2006
- Closed
- Dec 14, 2006
Inspection
- Advance Notice
- No
- Owner Type
- Private
- Union Status
- Yes
- Number of Employees
- 50
- Related Activity
- 1 referral
Violations and Penalties
- Total Violations
- 0
- Initial Penalties
- $0
- Penalties on Record
- $0
- Site Address
- State & Randolph, Chicago, IL 60610
- Industry
- 238110 Poured Concrete Foundation and Structure Contractors
Referral Inspection: This inspection record is categorized as a referral inspection in the DOL OSHA enforcement data. Referral inspections can result from another agency, another OSHA activity, or another source referring a potential hazard to OSHA.
Penalty amounts may differ from final amounts after settlement or judicial review. How to read these records
About these records
A company page groups inspections with the same normalized employer name, city and state; it is not a legal-entity identifier (how pages are grouped).
This page displays public OSHA enforcement data. Status text follows the DOL inspection record first and may include citation-level context when the inspection feed and citation records are out of sync. Penalty amounts shown reflect the latest penalty amounts on record in the DOL database and may differ from initial assessments or final amounts. This is not an official OSHA resource.
OSHA's public enforcement data does not publish a "guilty" or "not guilty" field for inspections. The closest outcome fields available are the citation counts, penalty amounts, contest dates, final-order dates, and the inspection close date shown on this page. How to interpret these status fields. How initial and current penalties are recorded.
OSHA may publish multiple citation rows in the same inspection with the same standard and penalty fields. Separate rows can still differ in OSHA metadata such as citation identifier, recorded instance count, exposed workers, or gravity value. Contest and Final Order columns show citation-level dates from OSHA's enforcement record. A dash means OSHA's record does not currently show that activity for the citation.
Source: U.S. Department of Labor OSHA incident investigation data (`osha_accident` + `osha_accident_injury`). Linked via `rel_insp_nr` to the inspection activity number (exact government key). Injury, body part, source and event values are OSHA's own codes. OSHA states that these fields are not coded according to the requirements under the Occupational Injury and Illness Classification System (OIICS). Only the values present in the OSHA record are listed; an incident with no value that resolves in OSHA's code table shows "Injury details not recorded". Where a record covers several people, each field lists every value recorded across them.
Understanding These Penalties
The maximum penalty for a serious violation in 2025 is $16,550 per violation. For willful violations, the range is $11,823 to $165,514. The current penalty column shows the latest amount on record in OSHA's database for each citation. When the current penalty differs from the initial penalty, OSHA's records show that the amount changed during the enforcement process, but this page does not determine the specific reason for each change. Penalty amounts are set by OSHA and adjusted annually for inflation.
50 inspections, 1983 to 2024. Each row is one inspection; point at or tap a row for its dates and totals.
Source: DOL OSHA enforcement data (inspections and violations), linked via activity_nr (exact government key).
Penalty changes: Amounts shown reflect what OSHA's enforcement record publishes. The reason for any change is not stated unless OSHA's record explicitly says so.
Short cases: When a case closed soon after it opened, the closed marker is drawn slightly to the right so both markers stay visible. Each row's card shows the exact dates.
The timeline shows the 50 most recent of 77 inspections with a recorded opening date.