Investigation report on the general production safety accident of ＂1 24＂ buried suffocation in Lijiahao coal preparation plant of Guoneng Baotou Energy Co., Ltd.

2025年9月17日 | admin | xwxq
　　At about 11: 27 on January 24, 2021, a safety accident of burying and suffocation occurred in the outsourced coal yard of Lijiahao Coal Preparation Plant of Guoneng Baotou Energy Co., Ltd., Chagan Village, Dongsheng District, resulting in one death and a direct economic loss of 1.8 million yuan.
　　According to "People’s Republic of China (PRC) Law on Work Safety", "Regulations on Reporting, Investigation and Handling of Work Safety Accidents" and other relevant national laws and regulations, on February 1, Ordos Municipal People’s Government established the "1 24" production safety accident of Lijiahao coal mine outsourcing coal yard of Guoneng Baotou Energy Co., Ltd., headed by the deputy director of the Municipal Emergency Management Bureau and attended by the responsible comrades of the Municipal Commission for Discipline Inspection (invited), the Public Security Bureau, the Emergency Management Bureau, the Energy Bureau, the Federation of Trade Unions and the Dongsheng District People’s Government.
　　In accordance with the principles of "four no-misses" and "scientific rigor, compliance with laws and regulations, seeking truth from facts and paying attention to practical results", the accident investigation team asked the parties to find out the course and cause of the accident, identified the nature and responsibility of the accident, and put forward suggestions on handling the relevant responsible units and personnel and suggestions on accident prevention and rectification measures. The relevant situation is now reported as follows:
　　I. Basic information of the accident
　　(a) the basic situation of the accident unit
　　1. Lijiahao Coal Mine of Guoneng Baotou Energy Co., Ltd. (hereinafter referred to as Lijiahao Coal Mine) is located in Chagan Village, Hantai Town, Dongsheng District, and was established on February 24, 2011; The company type is a branch of a limited liability company; The person in charge is Gu Shuwei; Approved production capacity: 6 million tons/year; Business scope of the company: coal mining, processing, washing, storage and transportation, sales, machinery manufacturing and repair, transportation, leasing, loading and unloading, gangue processing and sales; The unified social credit code of the obtained Business License is 91150602570641619N, and the business term is long-term. The number of the obtained Safety Production License is (Mongolia) MK Anxu Zhengzi [〔2014KG047〕], and it is valid until April 28, 2023. The license number of the obtained Mining License is C100000201002110056343, which is valid until February 9, 2040.
　　2. Lijiahao Coal Preparation Plant is a mine-type coal preparation plant, which was completed and put into trial production in April 2011, with a designed processing capacity of 12 million tons/year. The washing process is +6mm with dense medium shallow tank separation, and -6mm mixed coal is directly transported to the product warehouse for transportation. 3-0.15mm coarse coal slurry is dehydrated by a classification cyclone and then transported to the mixed coal warehouse, and -0.15mm fine coal slurry is recovered by plate-and-frame pressure filtration. The product structure is 4510 kcal/kg mixed coal and 4890 kcal/kg clean coal mixed with purchased coal for sale. The outsourced coal yard is located in the southeast of the main workshop of the coal preparation plant, and the coal shed covers an area of 203m× 110m = 22330m2. The designed annual storage capacity is 3 million tons, the maximum storage capacity is 120,000 tons, and the maximum coal storage height is 9 meters. The superstructure adopts spherical grid arch steel structure with a span of 110m and the highest height of the vault is 36.15m m. The arch frame is closed with blue galvanized color steel plate, and it is illuminated with FRP natural lighting plate. A natural ventilation building is set at the ridge line of the vault, with a height of 2.58m m.. There are 6 vehicle access gates in the coal yard. Four 4m×4m coal pits are arranged in the north-south direction in the middle of the coal yard, and each coal pit is provided with a 5.5m×5.5m iron grate (the grid is 300mm×300mm), and the center distance between the coal pits is 15m. At the time of the accident, the coal storage capacity of the coal yard was 48,000 tons, and the coal storage height above the coal pit affected by the accident was 8 meters.
　　(two) the establishment of the management organization of the accident unit
　　1. Lijiahao coal mine management organization is equipped with a party secretary (Shi Yongzhong), a mine manager (Gu Shuwei), a production deputy mine manager and chief engineer (Song Yaxin), a discipline inspection commission secretary and trade union chairman (Zheng Guoming), a safety deputy mine manager (Pan Shulin), an electromechanical deputy mine manager (Gao Jiandong), a tunneling deputy mine manager (Yan Binghui) and a coal preparation plant. There are four direct production units (No.1 fully mechanized mining team, No.1 anchor digging team, No.2 anchor digging team and No.3 anchor digging team), four underground auxiliary production units (ventilation preparation team, operation team, motorcade and electromechanical team), six functional departments (production command center, production technology office, resource management department, information monitoring department, electromechanical department and energy conservation and environmental protection department) and four government departments (Party committee office, electromechanical department). There are four auxiliary service units (material supply department, plumbing department, public security department and logistics department), one ground washing and processing unit (coal preparation plant) and one safety management unit (safety inspection department), and the safety inspection department supervises and manages the safety production of the whole mine.
　　2. Lijiahao Coal Preparation Plant is a ground washing and processing unit of Lijiahao Coal Mine, equipped with 1 factory director (Fan Youlin) and 3 deputy factory directors (Guo Ximing, Gaopingxiao and john young), and equipped with 8 departments: security inspection department, general office, dispatching room, production workshop, electromechanical workshop, loading station, laboratory and outsourcing office. The outsourcing office is responsible for the daily safety production management of coal storage management, working machines and tools in the outsourced coal yard. The security inspection department is responsible for promoting the standardization of safety production, the construction of environmental protection assessment standards for safety production in coal preparation plants and safety management.
　　(three) the scene of the accident.
　　The scene of the accident center is located in the outsourcing coal yard of Lijiahao Coal Preparation Plant, which is located in the southeast corner of Lijiahao Coal Mine, and is a blue arched building with the entrance in the northeast corner. Entering from the entrance, there is a coal pile in the coal yard, and there is a road leading to the top of the coal pile in the north. A coal pusher is parked on the south side of the coal pile, and the coal pusher is parked with its head north and tail south. The front of the coal pusher is marked "No.15". From the road leading to the top of the coal pile to the top of the coal pile, there is a man’s body on the ground at the top of the coal pile. The body showed a head northwest and a foot southeast. The body was covered with a cloth. Uncover the cover, and the body is wearing a gray jacket, a pair of gray trousers and a pair of black leather shoes. The south side of the corpse is the coal pushing work area, and the coal eye is below the coal pushing work area, and the photo is fixed.　 　
　　After investigation in other places, no trace material evidence was found.
　　(4) Examination of the corpse
　　According to the Appraisal Document (Dong) Gong (Si) Jian (Autopsy) Zi [2021] No.13 issued by the Public Security Judicial Appraisal Center of Dongsheng District, Ordos City, the appraisal opinion is that the deceased Li Zhengzhong died of mechanical asphyxia due to obstruction of mouth and nose and squeezing of chest, abdomen and back.
　　(five) the situation of the departments responsible for the supervision of production safety.
　　The daily safety supervision is undertaken by Ordos Energy Bureau, which has a comprehensive law enforcement bureau for coal safety production supervision, and the four law enforcement teams of the comprehensive law enforcement bureau conduct safety inspections on the coal mine according to their supervisory duties.
　　Second, the accident, emergency rescue and aftermath.
　　(1) The course of the accident
　　At 7 o’clock on January 24, 2021, the water system of Lijiahao Coal Preparation Plant stopped production. At 8 o’clock, the outsourced coal hauler entered the outsourced coal yard of the coal preparation plant and began to unload coal along the 3# and 4# coal pits. At the same time, according to the work arrangement, the labor dispatchers (workers of Ordos Zhongqing Labor Service Co., Ltd.) managed by the outsourcing office of the coal preparation plant, Li Zhengzhong, Xue Sanxiao, Gao Ruigang and Su Huihui, carried out coal pushing and unloading operations in the outsourcing coal yard. At 9: 40, He Xuying, the dispatcher of the coal preparation plant, started the production of purchased coal by using the coal feeders of No.1 and No.2 coal pits according to the notice of Wang Zhiqiang, the coal yard administrator. At 10: 40, He Xuying stopped using the coal feeders in No.1 and No.2 coal pits according to Wang Zhiqiang’s notice, and prepared to start using the coal feeders in No.3 and No.4 coal pits to produce purchased coal. At 10: 51, He Xuying started the coal feeders of 3# and 4# coal pits to produce purchased coal, and Li Zhengzhong, Xue Sanxiao, Gao Ruigang and Su Huihui began to push and unload coal from 3# and 4# coal pits. Li Zhengzhong drives a bulldozer to push coal from east to west at the east side of the outsourced coal yard to No.3 coal pit, Xue Sanxiao drives a bulldozer to push coal at No.4 coal pit, and Su Huihui and Gao Ruigang unload coal at the west side of No.3 coal pit. At 11: 15, Li Zhengzhong used his mobile phone to inform the No.3 coal pit on WeChat group that coal could not be discharged, and then stopped the bulldozer on the east side of No.3 coal pit and got off to check the situation of the coal pit. At this time, the coal body of the coal pit (with a height of 8 meters) suddenly collapsed, and Li Zhengzhong fell into the coal pit with the coal flow and was buried by coal.
　　(2) accident report
　　At 11: 27, Lijiahao coal preparation plant reported the accident information to Lijiahao coal mine dispatching room; At 11: 40, the dispatching room of Lijiahao Coal Mine reported the accident information to the dispatching room of Guoneng Baotou Energy Co., Ltd.; At 12: 23, Lijiahao Coal Mine reported the accident information to Ordos Energy Bureau; At 13: 20, Lijiahao Coal Mine reported the accident information to Dongsheng District Emergency Management Bureau. At 14: 30, Dongsheng District Emergency Management Bureau reported the accident information to the Municipal Emergency Management Bureau. At 15: 30, the Municipal Emergency Management Bureau reported the accident information to the Municipal Party Committee, the Municipal People’s Government and the Emergency Management Department of the autonomous region.
　　(three) emergency rescue and disposal
　　After the accident, at 11: 16, Su Huihui, the bulldozer driver, immediately used his mobile phone to inform He Xuying, the dispatcher of the coal preparation plant, to stop the No.3 coal feeder, and then used his mobile phone to inform Zhang Xuefei, deputy director of the outsourcing office of the coal preparation plant. Zhang Xuefei immediately informed relevant personnel and called two excavators to the scene for rescue. At 11: 23, Zhang Xuefei informed the dispatching room of the coal preparation plant to turn on the No.3 coal feeder, and saved people by digging up and lowering down, and informed Guo Ximing, deputy director of the coal preparation plant. Guo Ximing arrived at the scene at 11: 26 to organize rescue. At 11: 38, the mine rescue team of Guoneng Baotou Energy Co., Ltd. received a dispatching call from Lijiahao Coal Mine and requested rescue; At 12: 20, 11 members of the mine rescue team arrived at the scene to learn from the mine. The mine was using excavators to search for the buried person (Li Zhengzhong). After finding the buried person (Li Zhengzhong), the rescuers of the rescue team used rescue ropes to connect a person to the No.3 coal pit, and rescued the buried person (Li Zhengzhong) at 13: 27. The medical staff of Guangsha Hospital in Ordos City arrived at the scene for standby at 12 o’clock. After the buried person (Li Zhengzhong) was rescued, it was confirmed by the medical staff that there was no vital sign.
　　(four) the aftermath of the situation
　　After the accident, Lijiahao Coal Mine and Ordos Zhongqing Labor Service Co., Ltd. contacted the families of the deceased for the first time, docked with the families of the deceased, calmed their emotions, negotiated compensation matters, and properly handled the aftermath and compensation matters.
　　Three, the accident caused casualties and direct economic losses.
　　The accident caused one death and direct economic loss of 1.8 million yuan.
　　Situation of the dead:
　　Name, gender, age, degree of injury, address and ID number training
　　Li * Zhong male died at the age of 30. Wuchuan County, Inner Mongolia 150123 * * * 03080215 has been trained. On November 5, 2020, he obtained the safety training certificate of other employees in coal mining enterprises.
　　IV. Cause analysis and nature identification of the accident
　　(A) the direct cause
　　When Li Zhengzhong was driving a bulldozer to push the coal in the No.3 coal pit, the coal in the upper abdomen of the No.3 coal pit formed a cavity structure, which made it impossible for the coal pit to get down. Li Zhengzhong was indifferent to safety awareness. When he got off the bus to check the situation of the coal pit in violation of safety management regulations, the coal in the coal pit suddenly collapsed, and Li Zhengzhong fell into the coal pit with the coal flow and was buried by coal, causing suffocation and death.
　　(2) Indirect causes
　　1. The job site safety management is chaotic. First, effective measures have not been taken to calibrate the accurate position of the coal pit. Second, there are loopholes in the site safety management of coal preparation plant, and the responsibility for safety supervision and inspection is not in place. Third, the management personnel on the job site are negligent in management and can’t find and stop workers’ illegal operation behavior in time.
　　2. Safety training is a mere formality. The content of daily safety training is single and repetitive, without pertinence, and the effectiveness of safety management system and post operation procedures is poor, resulting in workers’ indifference to safety awareness, poor awareness of self-prevention, inadequate understanding of dangerous and harmful factors on the job site and insufficient understanding of the possible consequences of illegal operations.
　　3. Lijiahao Coal Mine did not supervise and inspect the safety production of coal preparation plant. The organization of safety supervision and inspection and safety training and education is ineffective, and the safety problems existing in coal preparation plants are neglected and neglected.
　　(3) Nature of the accident
　　After investigation, it is determined that the "1 24" buried suffocation production safety accident in Lijiahao Coal Preparation Plant of Guoneng Baotou Energy Co., Ltd. is a general production safety liability accident.
　　V. Suggestions on the handling of the responsible personnel and responsible units related to the accident
　　(1) Suggestions on handling the persons responsible for the accident
　　1. It is suggested that the person who is exempted from accountability (1 person)
　　Li Zhengzhong, bulldozer driver of Lijiahao Coal Preparation Plant (labor dispatcher of Ordos Zhongqing Labor Service Co., Ltd.). In view of his death in the accident, it is suggested to be exempted from liability.
　　2. It is recommended to hand over the investigation and handling personnel of judicial organs (1 person).
　　Zhang Xuefei, deputy director of the outsourcing office of Lijiahao Coal Preparation Plant (the leader on duty that day), is responsible for the safety management of the outsourcing coal yard operation site. Because of the crime of suspected major liability accident, it is suggested to hand it over to judicial organs for investigation and handling.
　　3. It is recommended that the internal processing personnel of the enterprise (9 persons).
　　(1) Li Pengkun, monitor of outsourcing office of Lijiahao coal preparation plant, is responsible for the on-site safety management of outsourced coal yard. Failing to perform safety duties seriously, failing to supervise and inspect the safety on the job site, failing to find and stop workers’ illegal operations in time. Responsible for the management of the accident, it is recommended to be dismissed according to the internal management regulations of the enterprise.
　　(2) john young, deputy director of Lijiahao coal preparation plant and director of outsourcing office, is responsible for the overall management of outsourcing office. Failing to perform safety duties seriously and carrying out safety supervision and inspection and safety training and education are ineffective, resulting in chaotic safety management on the job site and prominent illegal operation behavior of workers. Responsible for the management of the accident, it is recommended to be dismissed according to the management authority of the cadres and the internal management regulations of the enterprise.
　　(3) Guo Jinsheng, the security inspector of the security department of Lijiahao Coal Preparation Plant, is responsible for the supervision and inspection of on-site production safety. Failing to perform safety duties seriously, the on-site safety supervision and inspection of the outsourced coal yard is not in place, which makes it impossible to find and correct the illegal operation behavior of workers on the job site in time. Responsible for the supervision of the accident, it is recommended to give a warning according to the cadre management authority and the internal management regulations of the enterprise.
　　(4) Li Liang, deputy section chief of the security inspection department of Lijiahao coal preparation plant, presided over the overall work of the security inspection department and was responsible for the safety management of the coal preparation plant. Failing to perform safety duties seriously, failing to carry out safety supervision and inspection and safety training and education, and neglecting the safety problems existing in the outsourced coal yard. Responsible for the supervision of the accident, it is recommended to give a warning according to the cadre management authority and the internal management regulations of the enterprise.
　　(5) Guo Ximing, deputy director of Lijiahao Coal Preparation Plant, is responsible for the management of purchased coal purchase and loading, and is in charge of the outsourcing office, loading station and laboratory. Failing to perform safety duties seriously, failing to carry out safety supervision and inspection and safety training and education, and neglecting the safety problems existing in the outsourced coal yard. Responsible for the accident, it is suggested to give a demerit according to the cadre management authority and the internal management regulations of the enterprise.
　　(6) Gao Pingxiao, deputy director of Lijiahao Coal Preparation Plant, assists the director in safety and electromechanical management, and is responsible for the daily management of security inspection department and electromechanical workshop. Failing to perform safety duties seriously, failing to carry out safety supervision and inspection and safety training and education, and neglecting the safety problems existing in the outsourced coal yard. Responsible for the accident, it is suggested to give a demerit according to the cadre management authority and the internal management regulations of the enterprise.
　　(7) Fan Youlin, director of Lijiahao coal preparation plant, presided over the overall management of coal preparation plant. Failing to perform safety duties seriously, failing to supervise and inspect the safety production work of the unit, and neglecting the safety problems existing in the outsourced coal yard. Responsible for the accident, it is suggested to give a warning according to the cadre management authority and the internal management regulations of the enterprise.
　　(8) Zhang Xuefeng, deputy chief engineer and chief of safety inspection department of Lijiahao Coal Mine, is responsible for assisting the deputy mine manager in safety work. Failing to perform safety management duties seriously, organizing safety supervision and inspection and safety training and education is ineffective, and neglecting the safety problems existing in coal preparation plants. Responsible for the supervision of the accident, it is suggested to give it to informed criticism according to the cadre management authority and enterprise internal management regulations.
　　(9) Pan Shulin, deputy mine manager of Lijiahao Coal Mine, is responsible for the safety management, safety production standardization, safety risk pre-control management system construction and safety training of the whole mine (including coal preparation plant), and is in charge of the security inspection department and the energy conservation and environmental protection department. Failing to perform safety management duties seriously, organizing safety supervision and inspection and safety training and education is ineffective, and neglecting the safety problems existing in coal preparation plants. Responsible for the accident, it is suggested to give informed criticism according to the cadre management authority and internal management regulations of the enterprise.
　　4. It is recommended to give administrative punishment personnel (1 person)
　　Gu Shuwei, head of Lijiahao Coal Mine, presided over the overall work of mine administration. Failing to seriously perform the safety management responsibilities of the main person in charge, failing to supervise and inspect the safety production work of the unit, and failing to control the safety problems existing in the coal preparation plant. The above acts violate the provisions of Article 18 of the Law of People’s Republic of China (PRC) on Work Safety and bear the leadership responsibility for the accident. According to the provisions of Item 1 of Article 92 of the Law of People’s Republic of China (PRC) on Work Safety, it is suggested to impose a fine of 30% of the annual income of the previous year (RMB 129,500).
　　(2) Suggestions on handling the units responsible for the accident (1)
　　Lijiahao Coal Mine failed to supervise and inspect the safety production of coal preparation plant, and failed to organize safety supervision and inspection and safety training and education, which led to general production safety accidents. The above acts violate the provisions of Articles 18, 25 and 43 of the Law on Work Safety in People’s Republic of China (PRC). According to the provisions of Item 1 of Article 109 of the Law on Work Safety in People’s Republic of China (PRC), it is suggested to impose an administrative penalty of a fine of RMB 300,000.
　　(3) Other suggestions
　　1. According to "People’s Republic of China (PRC) Law on Safety in Production", "Regulations on the Reporting and Investigation of Production Safety Accidents" and other relevant laws and administrative regulations, it is suggested that the Municipal People’s Government instruct the Municipal Emergency Management Bureau to supervise the implementation of the administrative punishment of the units responsible for accidents and the responsible persons according to law.
　　2. Guoneng Baotou Energy Co., Ltd. shall implement the handling of relevant responsible personnel in strict accordance with relevant regulations, and report the implementation to the Municipal Emergency Management Bureau for the record.
　　3. The comprehensive law enforcement bureau of coal safety production supervision failed to effectively play the role of supervision and law enforcement, and the safety supervision and law enforcement work of coal mine ground facilities was not in place. It is suggested that the Municipal Energy Bureau be instructed to informed criticism within the system of the comprehensive law enforcement bureau of coal safety production supervision.
　　VI. Preventive Measures and Suggestions
　　(a) to strengthen education and training, improve safety awareness. Lijiahao coal mine should strengthen the education and training of employees, enhance the effectiveness of training, and constantly strengthen the safety awareness and self-protection ability of employees; Strictly implement the laws, regulations and operating rules of production safety, and put an end to illegal operation, illegal command and violation of labor discipline; Establish and improve the safety production reward and punishment mechanism, strengthen the publicity and education of safety production, and form a good safety production atmosphere.
　　(2) Strengthen the safety control on the job site. Lijiahao Coal Mine should strengthen the safety management and control of ground auxiliary projects such as coal preparation plants and outsourced coal yards, accurately identify and evaluate the hazards on the job site, implement risk classification and effectively control them. Job site management personnel should strictly perform safety management duties, strengthen supervision and inspection of front-line operators, and strictly guard against "three violations". Lijiahao coal mine and coal preparation plant should enter the job site in strict accordance with the regulations to carry out safety supervision and inspection, and timely discover and correct the dynamic safety hazards existing on the site.
　　(3) Further improve the hidden danger investigation and management system. Lijiahao Coal Mine should make inferences about the problems exposed in this accident, improve the hidden danger investigation and management system, and seriously carry out the hidden danger investigation and management work. The hidden danger investigation should be thorough and comprehensive, leaving no dead ends; The hidden dangers found must be rectified immediately in strict accordance with the requirements of "Five Implementations", and the hidden dangers after rectification shall be inspected and accepted to form closed-loop management.
　　(4) Strengthen technical management and improve procedures and measures. Lijiahao Coal Mine should combine the actual work of safety production, further sort out and improve the rules and regulations of safety production and the technical measures of various operations, form a complete system of safety production system, and ensure that all working procedures have rules to follow. Coal pushing, coal unloading and other operations should formulate detailed safety operation procedures, improve various safety technical measures and implement them.
　　(five) to strengthen the implementation of safety supervision responsibilities of municipal industry departments. The Municipal Energy Bureau should adhere to the principle that the industry must be in charge of safety and the business must be in charge of safety, earnestly perform their duties and strictly control; It is necessary to strengthen the training of law enforcement personnel, enhance law enforcement ability, and improve the standardization and specialization level of safety supervision and law enforcement; Conscientiously perform the duties of supervision and law enforcement, strengthen the safety supervision of belt coal conveying system in ground coal preparation plants, underground mines and power plants, and prevent similar accidents from happening again; Strict penalties are imposed on illegal acts, illegal command and illegal operations, and enterprises that do not have safe production conditions are resolutely suspended for rectification; Enterprises that fail to meet the conditions for safe production during the period of suspension of production and rectification or after rectification shall be submitted to the local people’s government for closure.