Appleton, WI —
OSHA Injury Report: 113 Darboy
Injury · Other recordable case
At a glance
On , an injury at 113 Darboy in Appleton, WI 54915 resulted in other recordable case. Employee was service associate in department Stores.
Where did this happen?
- Establishment
- 113 Darboy
- Parent company
- Kohls Department Stores
- Street
- 3226 E Calumet St
- City
- Appleton
- State
- WI
- ZIP
- 54915
- On-site location
- Salesfloor
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Merchandise Sale Return
What happened
Tripped over the bottom bar stand and tumbled to the ground. Tried to catch myself Face right elbow and right knee hit floor first.
Injury or illness
Contusion - Upper Extremities - Elbow
Object or substance involved
Fixture Display
Summary line
Tripped over the bottom bar stand and tumbled to the ground. Tried to catch myself Face right elbow and right knee hit floor first.
Employee and industry
- Job description
- service associate
- SOC code
- 9999 — Uncoded
- NAICS code
- 452210 — Department Stores
- NAICS vintage
- 2017
- Avg employees
- 86
- Total hours worked
- 79433
- EIN
- 133357362
- Establishment ID
- 1111387
- Employer case #
- K-23-07783
When (timing detail)
- Date of incident
- Time of incident
- 0:00:00.000
- Submitted
- 20FEB24:17:17:00
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.