Fond du Lac, WI —
OSHA Injury Report: 534-00472
Injury · Days away from work
At a glance
On , an injury at 534-00472 in Fond du Lac, WI 54935 resulted in days away from work. Employee was dELI CLERK in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 534-00472
- Parent company
- Roundy's
- Street
- 55 W Pioneer Rd
- City
- Fond du Lac
- State
- WI
- ZIP
- 54935
- On-site location
- BACKROOM DELI
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 169
Before the incident
WORKING IN DELI AND TURNED AROUND
What happened
EE was turned around in the back room deli when she backed into a deli table fell over the deli dept table and landed on her right shoulder
Injury or illness
Fracture Right Shoulder Fall deli department table
Object or substance involved
deli department table
Summary line
Fracture Right Shoulder Fall deli department table
Employee and industry
- Job description
- DELI CLERK
- SOC code
- 35-3023 — Fast Food and Counter Workers
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2012
- Avg employees
- 122
- Total hours worked
- 153119
- EIN
- 390854535
- Establishment ID
- 966327
- Employer case #
- 877502
When (timing detail)
- Date of incident
- Shift started
- 6:00
- Time of incident
- 14:15
- Filing year
- 2024
- Submitted
- 26FEB2025:20:58:00
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.