FOUNTAIN VALLEY, CA —
OSHA Injury Report: 0411 FOUNTAIN VALLEY CA WHSE
Injury · Other recordable case
At a glance
On , an injury at 0411 FOUNTAIN VALLEY CA WHSE in FOUNTAIN VALLEY, CA 92708 resulted in other recordable case. Employee was sUP HOURLY in wholesale Grocer.
Where did this happen?
- Establishment
- 0411 FOUNTAIN VALLEY CA WHSE
- Parent company
- COSTCO WHOLESALE
- Street
- 17900 NEWHOPE STREET
- City
- FOUNTAIN VALLEY
- State
- CA
- ZIP
- 92708
- On-site location
- TIRE SHOP
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
mounting a tire
What happened
Mounting a tire on the tire mounter and the beade set arm was pulled in to forhead
Injury or illness
Laceration Forehead
Object or substance involved
Tire Changer
Summary line
Laceration Forehead Pulling Tire Changer
Employee and industry
- Job description
- SUP HOURLY
- SOC code
- 00-9900 — Insufficient Information - NIOSH
- NAICS code
- 455211 — Wholesale Grocer
- NAICS vintage
- 2022
- Avg employees
- 404
- Total hours worked
- 580358
- EIN
- 911223280
- Establishment ID
- 1378489
- Employer case #
- WC608P107
When (timing detail)
- Date of incident
- Shift started
- 9:00
- Time of incident
- 16:20
- Filing year
- 2025
- Submitted
- 28FEB26:00:31:00
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.