OSHKOSH, WI —
OSHA Injury Report: 534-00478
Injury · Other recordable case
At a glance
On , an injury at 534-00478 in OSHKOSH, WI 54901 resulted in other recordable case. Employee was pRODUCE CLERK in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 534-00478
- Parent company
- Roundy's
- Street
- 1940 S Koeller St
- City
- OSHKOSH
- State
- WI
- ZIP
- 54901
- On-site location
- PRODUCE PREP ROOM AT SINK
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
USING SINK
What happened
EE WAS USING SINK AND PULLED ON FAUCET FAUCET BROKE AND EE FELL PAIN TO LOWER BACK
Injury or illness
Strained Posterior Low back Fall on same level FLOOR
Object or substance involved
FLOOR
Summary line
Strained Posterior Low back Fall on same level FLOOR
Employee and industry
- Job description
- PRODUCE CLERK
- SOC code
- 53-7065 — Stockers and Order Fillers
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2012
- Avg employees
- 126
- Total hours worked
- 167472
- EIN
- 390854535
- Establishment ID
- 966328
- Employer case #
- 882652
When (timing detail)
- Date of incident
- Shift started
- 9:00
- Time of incident
- 13:40
- 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.