Ankeny, IA ·
OSHA Injury Report: 1630 ANKENY IA WHSE
Injury · Other recordable case
At a glance
On , an injury at 1630 ANKENY IA WHSE in 4000 NE Spectrum Dr., Ankeny, IA 50021 resulted in other recordable case. Employee was membership clerk in wholesale Grocer.
Where did this happen?
- Establishment
- 1630 ANKENY IA WHSE
- Parent company
- COSTCO WHOLESALE
- Street
- 4000 NE Spectrum Dr.
- City
- Ankeny
- State
- IA
- ZIP
- 50021
- On-site location
- Breakroom
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Employee was eating on break
What happened
Employee was on break eating a mandarin that was provided for employees and bite down on a seed Their tooth boke
Injury or illness
Dental Teeth
Object or substance involved
Foreign Body
Summary line
Dental Teeth Right Side Foreign Body Foreign Body
Employee and industry
- Job description
- MEMBERSHIP CLERK
- SOC code
- 00-9900: Insufficient Information - NIOSH
- NAICS code
- 455211: Wholesale Grocer
- NAICS vintage
- 2022
- Employees at this establishment (2025 average)
- 226
- Hours worked at this establishment (2025 total)
- 341,366
- EIN
- 911223280
- Establishment ID
- 1378930
- Employer case #
- WC413G554
When (timing detail)
- Date of incident
- Shift started
- 14:00
- Time of incident
- 16:00
- Filing year
- 2025
- Submitted to OSHA
- 2026-02-28
More injuries at 1630 Ankeny IA Whse
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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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