FORT WAYNE, IN —
OSHA Injury Report: 1161 FORT WAYNE IN WHSE
Injury · Days away from work
At a glance
On , an injury at 1161 FORT WAYNE IN WHSE in FORT WAYNE, IN 46808 resulted in days away from work. Employee was sUP HOURLY in wholesale Grocer.
Where did this happen?
- Establishment
- 1161 FORT WAYNE IN WHSE
- Parent company
- COSTCO WHOLESALE
- Street
- 5110 VALUE DRIVE
- City
- FORT WAYNE
- State
- IN
- ZIP
- 46808
- On-site location
- WALK IN COOLER
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 34
- Days restricted or transferred
- 146
Before the incident
Stocking Dairy Cooler
What happened
Employee was pulling pallet of butter when he stopped the pallet jack butter fell onto EE s right arm
Injury or illness
Fracture Arm Right Side
Object or substance involved
Merchandise
Summary line
Fracture Arm Right Side Struck by a Moving Object Merchandise
Employee and industry
- Job description
- SUP HOURLY
- SOC code
- 00-9900 — Insufficient Information - NIOSH
- NAICS code
- 455211 — Wholesale Grocer
- NAICS vintage
- 2022
- Avg employees
- 294
- Total hours worked
- 444794
- EIN
- 911223280
- Establishment ID
- 1378779
- Employer case #
- WC80DH212
When (timing detail)
- Date of incident
- Time of incident
- 6:00
- Filing year
- 2025
- Submitted
- 28FEB26:00:32:00
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.