BLOOMINGTON, IL ·
OSHA Injury Report: NAI-0032-0032-03775 FAC-03775-BLOOMINGTON-IL
Injury · Other recordable case
At a glance
On , an injury at NAI-0032-0032-03775 FAC-03775-BLOOMINGTON-IL in 2103 NORTH VETERANS PARKWAY, BLOOMINGTON, IL 61704 resulted in other recordable case. Employee was food Clerk in supermarkets and Other Grocery (except Convenience) Stores.
Where did this happen?
- Establishment
- NAI-0032-0032-03775 FAC-03775-BLOOMINGTON-IL
- Parent company
- Jewel Food Stores Inc
- Street
- 2103 NORTH VETERANS PARKWAY
- City
- BLOOMINGTON
- State
- IL
- ZIP
- 61704
- On-site location
- FRONT END
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
[REDACTED] SORT
What happened
EE tripped over a pallet jack on the salesfloor that he had just put there
Injury or illness
Strained Posterior Upper back Trip Pallet jack
Object or substance involved
Pallet jack
Summary line
EE tripped over a pallet jack on the salesfloor that he had just put there
Employee and industry
- Job description
- Food Clerk
- SOC code
- 53-7065: Stockers and Order Fillers
- NAICS code
- 445110: Supermarkets and Other Grocery (except Convenience) Stores
- NAICS vintage
- 2022
- Employees at this establishment (2025 average)
- 103
- Hours worked at this establishment (2025 total)
- 113,279
- EIN
- 361282500
- Establishment ID
- 1140821
- Employer case #
- 89955
When (timing detail)
- Date of incident
- Shift started
- 07:00
- Time of incident
- 11:05
- Filing year
- 2025
- Submitted to OSHA
- 2026-02-21
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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.
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