PEWAUKEE, WI —
OSHA Injury Report: 1101 PEWAUKEE WI WHSE
Injury · Job transfer or restriction
At a glance
On , an injury at 1101 PEWAUKEE WI WHSE in PEWAUKEE, WI 53072 resulted in job transfer or restriction. Employee was tIRE INSTALLER in wholesale Grocer.
Where did this happen?
- Establishment
- 1101 PEWAUKEE WI WHSE
- Parent company
- COSTCO WHOLESALE
- Street
- 443 PEWAUKEE ROAD
- City
- PEWAUKEE
- State
- WI
- ZIP
- 53072
- On-site location
- TIRE SHOP
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 18
Before the incident
pushing bottom bead of tire
What happened
Was trying to push the bottom bead onto tire hand slipped on tire rubber twisted my back fast and hurt me
Injury or illness
Strain Sprain Back Lower
Object or substance involved
Tire
Summary line
Strain Sprain Back Lower Twisted Tire
Employee and industry
- Job description
- TIRE INSTALLER
- SOC code
- 9999 — Uncoded
- NAICS code
- 455211 — Wholesale Grocer
- NAICS vintage
- 2022
- Avg employees
- 278
- Total hours worked
- 410111
- EIN
- 911223280
- Establishment ID
- 1378751
- Employer case #
- WC413G4146
When (timing detail)
- Date of incident
- Shift started
- 11:00
- Time of incident
- 12:50
- Filing year
- 2024
- Submitted
- 28FEB2025:21:43:00
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.