Portland, OR —
OSHA Injury Report: Foodservice Pacific NW - 1017
Injury · Days away from work
At a glance
On , an injury at Foodservice Pacific NW - 1017 in Portland, OR 97230 resulted in days away from work. Employee was driver Formula PFG.
Where did this happen?
- Establishment
- Foodservice Pacific NW - 1017
- Street
- 19606 NE San Rafael St
- City
- Portland
- State
- OR
- ZIP
- 97230
- On-site location
- Foodservice Pacific NW 1017 Employee front parking lot
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 11
Before the incident
Fall Slip On Ice or Snow
What happened
Employee states he slipped and fell face first in icy parking lot while arriving for work at the [REDACTED] OpCo He states he bruised his nose chin wrist and has sore neck
Injury or illness
Cause Fall Slip or Trip Injury Body Part Neck Soft Tissue Body Part Position Detail Cause Fall Slip On Ice or Snow
Object or substance involved
Walking Working Surface Uneven Surface not ramp
Summary line
Cause Fall Slip or Trip Injury Body Part Neck Soft Tissue Body Part Position Detail Cause Fall Slip On Ice or Snow
Employee and industry
- Job description
- Driver Formula PFG
- SOC code
- 9999 — Uncoded
- NAICS code
- 424410
- NAICS vintage
- 2012
- Avg employees
- 154
- Total hours worked
- 320359
- EIN
- 840629503
- Establishment ID
- 205907
- Employer case #
- 1201WC2403
When (timing detail)
- Date of incident
- Shift started
- 2:30
- Time of incident
- 2:30
- Filing year
- 2024
- Submitted
- 28FEB2025:16:50:00
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.