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Safety Incidents OSHA Severe Injury Reports · 2015–2025

OSHA Injury Report: 4223-M0100

Injury · Other recordable case

On , an injury at 4223-M0100 in APPLETON, WI 54914 resulted in other recordable case. Employee was sales Team Member in all Other General Merchandise Stores.

Establishment
4223-M0100
Street
3035 W WISCONSIN AVENUE
City
APPLETON
State
WI
ZIP
54914
On-site location
Store parking lot
Outcome
Other recordable case (code 4)
Type
Injury (code 1)

He was working outside - he had been putting liquid on the field for the generator. He was coming back inside the store on the truck.

When he stepped out of the truck he slipped on ice and hit the back of his head on the running board.

Scalp contusion

Ice and running board

Stepped out of truck and slipped on ice fell and hit back of head on running board.

Job description
Sales Team Member
SOC code
41-2031 — Retail Salespersons
NAICS code
452319 — All Other General Merchandise Stores
NAICS vintage
2017
Avg employees
235
Total hours worked
250009
EIN
410806238
Establishment ID
446206
Employer case #
254667
Date of incident
Shift started
5:51:00.000
Time of incident
10:40:00.000
Submitted
06FEB24:21:29:00

Data from OSHA ITA Form 300/301 electronic submissions, filing year unspecified. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.