JACKSONVILLE, FL ·
OSHA Injury Report: Store 0631
Injury · Other recordable case
At a glance
On , an injury at Store 0631 in 4495 ROOSEVELT BLVD STE 103, JACKSONVILLE, FL 322103390 resulted in other recordable case. Employee was deli Clerk in supermarkets and other grocery (except convenience) stores.
Where did this happen?
- Establishment
- Store 0631
- Parent company
- Publix Super Markets Inc.
- Street
- 4495 ROOSEVELT BLVD STE 103
- City
- JACKSONVILLE
- State
- FL
- ZIP
- 322103390
- On-site location
- Deli Sales Floor
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Walking
What happened
Walking through the deli to go review orders
Injury or illness
Bruise Contusion Other Shoulder Right
Object or substance involved
Rug Carpeted
Summary line
Right shoulder contusion pain from tripping on rug
Employee and industry
- Job description
- Deli Clerk
- SOC code
- 35-3023: Fast Food and Counter Workers
- NAICS code
- 445110: Supermarkets and other grocery (except convenience) stores
- NAICS vintage
- 2012
- Employees at this establishment (2025 average)
- 245
- Hours worked at this establishment (2025 total)
- 309,875
- EIN
- 590324412
- Establishment ID
- 697762
- Employer case #
- EV2025905
When (timing detail)
- Date of incident
- Shift started
- 05:00
- Time of incident
- 05:00
- Filing year
- 2025
- Submitted to OSHA
- 2026-02-25
More injuries at Store 0631
View Store 0631's full OSHA safety record →
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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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