Jasper, TN ·
OSHA Injury Report: Surebuilt CCS Holdings, LLC dba Jasper Materials
Injury · Job transfer or restriction
At a glance
On , an injury at Surebuilt CCS Holdings, LLC dba Jasper Materials in 150 Hickman Road, Jasper, TN 37347 resulted in job transfer or restriction. Employee was assembler in fabricated structural metal manufacturing.
Where did this happen?
- Establishment
- Surebuilt CCS Holdings, LLC dba Jasper Materials
- Parent company
- Surebuilt CCS Holdings, LLC dba Jasper Materials
- Street
- 150 Hickman Road
- City
- Jasper
- State
- TN
- ZIP
- 37347
- On-site location
- Assembly
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 117
Before the incident
**Injury occurred [REDACTED] employee is still on job restriction. Final appointment is coming up on [REDACTED] for a full release. Stacking concrete forms
What happened
employee tried to stack a concrete form without assistance. He knew that he was supposed to have another person helping him.
Injury or illness
pulled muscle
Object or substance involved
concrete form
Summary line
pulled muscle in left shoulder from lifting concrete form
Employee and industry
- Job description
- Assembler
- SOC code
- 51-2099: Assemblers and Fabricators, All Other
- NAICS code
- 332312: Fabricated structural metal manufacturing
- NAICS vintage
- 2022
- Employees at this establishment (2023 average)
- 65
- Hours worked at this establishment (2023 total)
- 78,078
- EIN
- 862752734
- Establishment ID
- 921767
- Employer case #
- 1
When (timing detail)
- Date of incident
- Time of incident
- Not known — the employer filed this case without a time of day.
- Filing year
- 2023
- Submitted to OSHA
- 2024-02-02
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2023. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
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