Phoenix, AZ ·
OSHA Injury Report: Forms + Surfaces Phoenix
Injury · Job transfer or restriction
At a glance
On , an injury at Forms + Surfaces Phoenix in 1025 N 71st Avenue, Phoenix, AZ 85043 resulted in job transfer or restriction. Employee was manufacturing Associate in ornamental metalwork manufacturing.
Where did this happen?
- Establishment
- Forms + Surfaces Phoenix
- Parent company
- Forms and Surfaces
- Street
- 1025 N 71st Avenue
- City
- Phoenix
- State
- AZ
- ZIP
- 85043
- On-site location
- Building 2
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 7
Before the incident
Removing foam from the top of a pallet.
What happened
The employee stepped on a pallet to remove pieces of foam from material. With stepping on the pallet the employee fell backwards and twisted their back.
Injury or illness
Radiculopathy in lumbar region from same level fall
Object or substance involved
Pallet
Summary line
Radiculopathy in lumbar region from same level fall
Employee and industry
- Job description
- Manufacturing Associate
- SOC code
- 00-9900: Insufficient Information - NIOSH
- NAICS code
- 332323: Ornamental metalwork manufacturing
- NAICS vintage
- 2012
- Employees at this establishment (2025 average)
- 266
- Hours worked at this establishment (2025 total)
- 400,670
- EIN
- 251476717
- Establishment ID
- 1064648
- Employer case #
- 2
When (timing detail)
- Date of incident
- Time of incident
- 21:30
- Filing year
- 2025
- Submitted to OSHA
- 2026-02-17
More injuries at Forms + Surfaces Phoenix
View Forms + Surfaces Phoenix's full OSHA safety record →
More injuries in this industry (NAICS 332323)
More injuries in AZ
Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2025. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
Look up any company's OSHA accident reports by company, or browse severe injury reports by year, state, and company.