JACKSONVILLE, FL ·
OSHA Injury Report: Store 0631
Injury · Other recordable case
At a glance
On , an injury at Store 0631 in 4495 ROOSEVELT BLVD STE 103, JACKSONVILLE, FL 322103390 resulted in other recordable case. Employee was deli Clerk in supermarkets and other grocery except convenience stores.
Where did this happen?
- Establishment
- Store 0631
- Parent company
- Publix Super Markets Inc
- Street
- 4495 ROOSEVELT BLVD STE 103
- City
- JACKSONVILLE
- State
- FL
- ZIP
- 322103390
- On-site location
- Deli Preparation Room
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
No Specific Activity
What happened
Slicing cheese
Injury or illness
Bruise Contusion Strain Shoulder Left Shoulder Right
Object or substance involved
Electric Cord
Summary line
Right shoulder strain left shoulder contusion assoc was stepping backwards and tripped over electric cord
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
- Employees at this establishment (2024 average)
- 244
- Hours worked at this establishment (2024 total)
- 317,070
- EIN
- 590324412
- Establishment ID
- 697762
- Employer case #
- EV20248603
When (timing detail)
- Date of incident
- Shift started
- 10:00
- Time of incident
- 13:30
- Filing year
- 2024
- Submitted to OSHA
- 2025-02-27
More injuries at Store 0631
View Store 0631's full OSHA safety record →
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2024. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
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