Vancouver, WA —
OSHA Injury Report: 1003 Vancouver SE
Injury · Other recordable case
At a glance
On , an injury at 1003 Vancouver SE in Vancouver, WA 98684 resulted in other recordable case. Employee was service Assoiva in department Store.
Where did this happen?
- Establishment
- 1003 Vancouver SE
- Parent company
- Kohls Inc
- Street
- 17001 SE Mill Plain Blvd
- City
- Vancouver
- State
- WA
- ZIP
- 98684
- On-site location
- Customer Service
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Office Work
What happened
I was carrying 3 cash draws to the cash office and there was a box sticking out and I tripped on the box. I feel forward into the hanger rack and hit both my arm and nose on the hangers and both knees on the floor.
Injury or illness
Contusion Lower Extremities Knee
Object or substance involved
Box Carton Tote
Summary line
I was carrying 3 cash draws to the cash office and there was a box sticking out and I tripped on the box. I feel forward into the hanger rack and hit both my arm and nose on the hangers and both knees on the floor.
Employee and industry
- Job description
- Service Assoiva
- SOC code
- 9999 — Uncoded
- NAICS code
- 452210 — Department Store
- NAICS vintage
- 2017
- Avg employees
- 68
- Total hours worked
- 69096
- EIN
- 133357362
- Establishment ID
- 1307148
- Employer case #
- K-24-09424
When (timing detail)
- Date of incident
- Time of incident
- 21:00
- Filing year
- 2024
- Submitted
- 21FEB2025:21:22:00
Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2024. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.