DELAVAN, WI —
OSHA Injury Report: 4223-M5400
Injury · Other recordable case
At a glance
On , an injury at 4223-M5400 in DELAVAN, WI 53115 resulted in other recordable case. Employee was sales Team Lead in all Other General Merchandise Stores.
Where did this happen?
- Establishment
- 4223-M5400
- Street
- 1516 E. GENEVA STREET
- City
- DELAVAN
- State
- WI
- ZIP
- 53115
- On-site location
- Sales floor
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
He was moving bags of softener salt
What happened
As he was moving one of the bags (approx. 40lbs) and throwing onto a pallet he felt something spasm in his lower back.
Injury or illness
low back strain
Object or substance involved
bags of softener salt
Summary line
Lifted bag weighing 40lbs to throw onto a pallet low back strain.
Employee and industry
- Job description
- Sales Team Lead
- SOC code
- 41-1011 — First-Line Supervisors of Retail Sales Workers
- NAICS code
- 452319 — All Other General Merchandise Stores
- NAICS vintage
- 2017
- Avg employees
- 138
- Total hours worked
- 156349
- EIN
- 410806238
- Establishment ID
- 446254
- Employer case #
- 259670
When (timing detail)
- Date of incident
- Shift started
- 6:51:00.000
- Time of incident
- 13:30:00.000
- Submitted
- 09FEB24:20:20:00
Source
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.