Phoenix, AZ —
OSHA Injury Report: Forms + Surfaces Phoenix
Injury · Job transfer or restriction
At a glance
On , an injury at Forms + Surfaces Phoenix in Phoenix, AZ 85043 resulted in job transfer or restriction. Employee was bagger 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 1
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 76
Before the incident
The employee was lifting glass from a caster table to be stacked onto an A-frame.
What happened
While the employee was lifting the glass panel the glass flexed and broke into two pieces. This caused the employee to release the glass being held in his right hand which then fell onto their left forearm causing a laceration.
Injury or illness
Laceration of the left forearm.
Object or substance involved
Glass panel
Summary line
Laceration to left forearm from broken glass
Employee and industry
- Job description
- Bagger
- SOC code
- 53-7062 — Laborers and Freight, Stock, and Material Movers, Hand
- NAICS code
- 332323 — Ornamental metalwork manufacturing
- NAICS vintage
- 2012
- Avg employees
- 266
- Total hours worked
- 400670
- EIN
- 251476717
- Establishment ID
- 1064648
- Employer case #
- 7
When (timing detail)
- Date of incident
- Time of incident
- 12:30
- Filing year
- 2025
- Submitted
- 17FEB26:13:40:00
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.