UNITED STATES
DEPARTMENT OF LABOR
MINE SAFETY AND HEALTH ADMINISTRATION
SOUTH CENTRAL DISTRICT
Metal and Nonmetal Mine Safety and Health
Accident Investigation Report
Surface Nonmetal Mine
(Limestone)
Fatal Explosion of Vessel Under Pressure
Hunter Plant
Colorado Materials Incorporated
New Braunfels, Comal County, Texas
I.D. No. 41-03430
April 22, 1998
By
Willard J. Graham
Supervisory Metal and Nonmetal Mine Inspector
Benny W. Lara
Metal and Nonmetal Mine Inspector
James Smiser
Metal and Nonmetal Mine Inspector
and
Eugene Hennen
Technical Support - Mechanical Engineer
Originating Office
Mine Safety and Health Administration
South Central District
1100 Commerce Street, Room 4C50
Dallas, Texas 75242-0119
Doyle D. Fink
District Manager
GENERAL INFORMATION
Bobby Joe Mendez, serviceman, age 28, was fatally injured at about 1: 15 p.m., on
April 22, 1998, when he was struck by pieces of a tire which exploded after heat
was applied to the wheel hub/brake assembly. Scott Holmes, welder, and Warren
Monteque, diesel mechanic, were also injured. Mendez had about eight years
mining experience, all as a serviceman at this operation. Mendez, Holmes and
Monteque had not received training in accordance with 30 CFR Part 48.
MSHA was notified at 2:50 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 Hunter Plant, a surface crushed stone operation, owned and operated by
Colorado Materials, Inc., was located near New Braunfels, Coma1 County, Texas.
The principal operating officials were John R. Janek and Gary L. Brim,
Governmental Affairs Officer and Safety Director. The mine was normally
operated two, lo-hour shifts a day, five to six days a week. A total of 100 persons
was employed.
Limestone was mined by drilling and blasting multiple benches in the pit. Broken
stone was trucked to the plant for upgrading. The finished product was sold to
various customers for use as construction aggregate.
The last regular inspection at this operation was completed on April 11, 1998.
Another inspection was conducted at the conclusion of this investigation.
Physical Factors Involved
The accident occurred behind the main shop building. The equipment involved
was a Caterpillar 63 1, series.11 pan scraper, which had been taken out of service
for brake repairs. The rear tire and wheel assemblies had been removed to
facilitate replacement of the brake drums and linings. The tire was a Type B
Michelin, tubeless steel cord radial, size 37.25RX35XR. It was rated two stars
which equated to a ply rating of 48. Estimated weight was 2000 pounds. The tire
diameter was 89 inches and the tread width was 3 1 inches. The rim diameter was
36 inches. Normal operating pressure was 76 pounds per square inch (psi).
Pressure measurements indicated that the opposite tire was inflated to 50 psi.
Additional testing and analysis is detailed in Appendix II.
The brake drum was attached to the wheel by 45 steel studs and fasteners, 5/8-
inch in diameter. The brake, drum was made of cast iron, approximately 1 - inch
thick.
Weather conditions at the time of the accident were 80-85 degrees F, sunny and
clear.
Description of Accident
On the day of the accident, Bobby Joe Mendez, (victim) reported for work at 6:00
a.m., his normal starting time. Mendez worked at the main shop under the
direction of John Keller, equipment maintenance supervisor. His primary
responsibilities were to service mine equipment and to help as needed at the shop.
Keller assigned Chris Haseloff, mechanic helper, and Alfonso Peneulaz,
equipment operator, to complete the brake repairs on the Caterpillar scraper, a job
they had started the previous day.
Haseloff, Peneulaz and Mendez washed debris and mud from the tire hub
assemblies. The left rear brake drum fasteners were removed from the wheel
assembly and they moved on to the right rear. After removing the fasteners, they
hammered and pried on the brake drum without success. The tire assembly was
then moved behind the shop and placed on its side with the brake drum up.
Penetrating oil was applied to the stud threads and double nutting the stud was
attempted. They also drove wedges between the wheel and the brake drum flange
in an effort to loosen the drum. After a great amount of effort, Keller decided to
split the brake drum.
At about 11:30 a.m., Scott Holmes, welder, drove his maintenance truck, which
was equipped with a welding machine, to the rear of the shop near the tire.
Holmes attempted to cut a slot in the brake drum with a carbon arc air cutter, butthe carbon arc was ineffective in cutting the cast iron drum, so Holmes decided to
use the oxygen/acetylene torch. Holmes climbed atop the tire and cut a one-inch
slot on opposite sides of the drum. One side was cut completely in two, while the
other side was cut to the mounting flange. Warren Monteque, diesel mechanic,
arrived and they all stopped to eat lunch.
Haseloff and Peneulaz finished eating early and resumed work on the wheel.
Haseloff dragged a water hose from the shop and wet the wheel hub/brake
assembly to cool it. They pried and hammered on the brake drum to no avail.
Haseloff and Peneulaz gave up and went into the shop to begin installation of the
new brake part for the left rear of the scraper. Holmes, Montegue and Mendez
returned about 1:OO p.m. and applied water to the hub assembly. They placed a
pry bar in the slot which had been cut in the drum. The drum moved a bit and
then the tire exploded. Holmes had walked around the tire to obtain a wedge from
the maintenance truck when the tire exploded. He was blown against the truck's
dual wheels. Monteque was standing near the tire on the other side and Mendez
was at the shop wall. The explosion turned the tire completely inside out and sent
pieces of the side wall in all directions. The tire came to rest beside the
maintenance truck driver's side door, with the brake drum facing down. The
projected pieces of tire were mostly contained between the shop and the
warehouse building nearby. Both buildings sustained damage. The maintenance
truck was extensively damaged. The force of the blast was detected up to one-half
mile from the site.
Many employees rushed to the scene of the accident. Holmes and Monteque were
given first aid and airlifted to a medical center in San Antonio, Texas, where they
were treated for their injuries. Mendez was pronounced dead at the scene a short
time later.
Conclusion
Use of the torch to cut the brake drum transferred sufficient heat to ignite material
within the tire, generating combustible vapors and increased pressure. Heat from
the burning material ignited the combustible vapors within the tire causing it to
explode.
Violations
Order No. 4324226 was issued to Colorado Materials, Inc. on April 22, 1998,
under the provisions of Section 103 (k) of the Mine Act to
ensure the safety of persons until the affected areas of the mine could return to
normal.
This order was terminated on June 25, 1998, after it was determined that the mine
could safely resume normal operations.
Citation No. 7861378 was issued to Colorado Materials, Inc. on June 25, 1998,
under the provisions of Section 104 (d) (1) of the Mine Act for violation of 30
CFR 56.4500:
A fatal accident and two serious injuries occurred at this operation on April 22,
1998, when a tire exploded while three miners were attempting to remove a brake
drum from its rim. The equipment manufacturer's operation and maintenance
manual warns of the explosive hazards generated by welding or heating rim
components of tires. The supervisor engaged in aggravated conduct constituting
more than ordinary negligence, in that he instructed one of the miners to cut a slot
in the brake drum with an oxygen/acetylene torch. This generated combustible
gases inside the tire. Failure to assure safe work procedures is a serious lack of
reasonable care and is an unwarrantable failure to comply with a mandatory safety
standard.
This citation was terminated on June 25, 1998, after the company changed their
wheel/brake maintenance procedures. Tires will be dismounted and removed from
the wheel. Additionally, the company has installed a 1500-gallon nitrogen tank
for the purpose of replacing compressed air in all tires used on heavy equipment.
Appendices
I. List of Participants in the Investigation.
II. Executive Summary of Field Examination / Laboratory Analysis
Appendix I.
| Colorado Materials, Inc.
|
| Johnny Weisman
| Chief Executive Officer
|
| Gary R. Janek
| Plant Manager
|
| Gary L. Brim
| Government Affairs Officer and Safety Director
|
| Robert Richardson
| Mine Safety Officer
|
| Bruce Wymer
| Equipment Manager
|
| John R. Keller
| Equipment Maintenance Supervisor
|
| William M. Knolle
| Attorney
|
Mine Safety and Health Administration
|
| Willard J. Graham
| Supervisory Mine Safety and Health Inspector
|
| Benny W. Lara
| Mine Safety and Health Inspector
|
| James Smiser
| Mine Safety and Health Inspector
|
| Eugene Hennen
| Mechanical Engineer
|
Appendix II. - Executive Summary of Field Examination/ Laboratory
Analysis for a Fatal Tire Explosion Accident at the Colorado Materials, Inc.,
conducted by MSHA Technical Support.
A laboratory investigation was conducted at the Approval & Certification Center
(A&CC) as part of a technical assistance request to Metal and Nonmetal Safety
and Health's South Central District.on the tire explosion accident that occurred at
the Colorado Materials surface limestone aggregate facility. The laboratory
investigation included literature research, visual and microscopic examination,
torch cutting tests on the brake drum of the recovered wheel rim, and ignition and
heating tests on the damaged and undamaged liner materials.
After completion of the field examination and the laboratory testing and analysis,
it was concluded that the most likely event that caused the accident is that cutting
with the torch transferred sufficient heat into the tire to ignite combustible material
within the tire. The tire liner ignited and smoldered for a length of time, filling the
tire with combustible vapors. The tests show the tire inner liner material is
combustible. Physical examination and thermal analysis of the damaged liner
material indicates that combustion of the tire liner had actually taken place. Tests
indicate the torch used on the drum was capable of generating temperatures on the
tire side of the rim sufficient to ignite the tire liner when cuts similar to those
made by plant workers were conducted. The laboratory test cuts were conducted
without the presence of the tire. The tire would have trapped the heat generated
by the cutting operation. Thus, the temperatures generated in the tire prior to the
explosion could readily have been higher than measured during testing. The time
delay between the completion of hot work and the explosion would have been
favorable to create an explosive atmosphere within the tire from gases generated
by a smoldering fire.
The magnitude of the accident damage can be explained by a combustion
explosion. Since a smoldering fire in the tire would cause some internal heating
before the explosion, this increase in temperature would create an initial pressure
above the original pressure in the tire. Based upon pressure measurements taken
on the opposite tire, the exploded tire probably contained about 50 psig of air prior
to work being performed on it. The pressurized air would have contained more
total oxygen than at atmospheric pressure, thus allowing for a longer burning time.
The pressurized air could also increase the ability of any combustible material to
ignite by lowering ignition temperatures below those observed in the laboratory tests.
As the tire smoldered, the generation of volatiles and concurrent oxygen consumption
would eventually drive the mixture through the explosive range. Given that the tire before the explosion was at an initial pressure of about 50 psig, a maximum explosion pressure of approximately 400 psig could have developed. This explosion pressure would be 4 times greater than would develop from a combustion explosion at normal atmospheric pressure. The rate of explosion pressure rise would have been extremely fast and would be over 3 times greater than would develop from a combustion explosion at normal atmospheric pressure. This magnitude of maximum pressure and rate of pressure rise from an explosion in the tire would be consistent with the physical damage observed at the accident site.
Related Fatal Alert Bulletin:
FAB98M16
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