Sun Prairie, WI —
OSHA Injury Report: 1121 SUN PRAIRIE WI WHSE
Injury · Job transfer or restriction
At a glance
On , an injury at 1121 SUN PRAIRIE WI WHSE in Sun Prairie, WI 53590 resulted in job transfer or restriction. Employee was mGR DEPT W OT in wholesale Grocer.
Where did this happen?
- Establishment
- 1121 SUN PRAIRIE WI WHSE
- Parent company
- COSTCO WHOLESALE
- Street
- 2850 Hoepker Rd
- City
- Sun Prairie
- State
- WI
- ZIP
- 53590
- On-site location
- FRONT END
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 14
Before the incident
Stepping off a forklift
What happened
While stepping off a forklift toe caught the lip of the brake plate and tripped He fell to the ground
Injury or illness
Strain Sprain Leg
Object or substance involved
Forklift
Summary line
Strain Sprain Leg Right Side Stepped In On or Off Forklift
Employee and industry
- Job description
- MGR DEPT W OT
- SOC code
- 9999 — Uncoded
- NAICS code
- 455211 — Wholesale Grocer
- NAICS vintage
- 2022
- Avg employees
- 322
- Total hours worked
- 468465
- EIN
- 911223280
- Establishment ID
- 1378766
- Employer case #
- WC413G3408
When (timing detail)
- Date of incident
- Shift started
- 3:45
- Time of incident
- 7:00
- 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.