MAYNARDVILLE, TN —
OSHA Injury Report: 680 FC MAYNARDVILLE TN
Injury · Days away from work
At a glance
On , an injury at 680 FC MAYNARDVILLE TN in MAYNARDVILLE, TN 378073618 resulted in days away from work. Employee was cook Over in supermarket.
Where did this happen?
- Establishment
- 680 FC MAYNARDVILLE TN
- Parent company
- K VA T Food Stores Inc.
- Street
- 4344 MAYNARDVILLE HIGHWAY
- City
- MAYNARDVILLE
- State
- TN
- ZIP
- 378073618
- On-site location
- Deli Prep
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 2
- Days restricted or transferred
- 15
Before the incident
walking by smoker
What happened
Walking by smoker tripped on cardboard in the floor fell on both knees and [REDACTED] shoulder
Injury or illness
Bilateral knee contusions R shoulder strain
Object or substance involved
cardboard in floor
Summary line
Bilateral knee contusions R shoulder strain cardboard in floor Walking to back to do dishes walked by smoker tripped on cardboard in the floor hit floor hard.
Employee and industry
- Job description
- Cook Over
- SOC code
- 35-2021 — Food Preparation Workers
- NAICS code
- 445110 — Supermarket
- NAICS vintage
- 2022
- Avg employees
- 159
- Total hours worked
- 224557
- EIN
- 550421484
- Establishment ID
- 1293487
- Employer case #
- 79680
When (timing detail)
- Date of incident
- Shift started
- 7:00
- Time of incident
- 8:55
- Filing year
- 2025
- Submitted
- 16JAN26:21:04:00
Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2025. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.