BLOOMINGTON, IL ·
OSHA Injury Report: NAI-0032-0032-03775 FAC-03775-BLOOMINGTON-IL
Injury · Job transfer or restriction
At a glance
On , an injury at NAI-0032-0032-03775 FAC-03775-BLOOMINGTON-IL in 2103 NORTH VETERANS PARKWAY, BLOOMINGTON, IL 61704 resulted in job transfer or restriction. Employee was food Clerk in supermarkets and Other Grocery (except Convenience) Stores.
Where did this happen?
- Establishment
- NAI-0032-0032-03775 FAC-03775-BLOOMINGTON-IL
- Parent company
- Jewel Food Stores, Inc
- Street
- 2103 NORTH VETERANS PARKWAY
- City
- BLOOMINGTON
- State
- IL
- ZIP
- 61704
- On-site location
- RECEIVING
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 11
Before the incident
RECEIVING UNLOADING TRUCK
What happened
[REDACTED] was in receiving checking in a vendor he moved a pallet jack in front of a pallet to get ready to move the pallet. While he was talking to the vendor the pallet jack rolled behind him and he stepped back and fell
Injury or illness
Bruised Left Elbow Fall PALLET JACK
Object or substance involved
PALLET JACK
Summary line
[REDACTED] was in receiving checking in a vendor he moved a pallet jack in front of a pallet to get ready to move the pallet. While he was talking to the vendor the pallet jack rolled behind him and he stepped back and fell
Employee and industry
- Job description
- Food Clerk
- SOC code
- 53-7065: Stockers and Order Fillers
- NAICS code
- 445110: Supermarkets and Other Grocery (except Convenience) Stores
- NAICS vintage
- 2022
- Employees at this establishment (2023 average)
- 98
- Hours worked at this establishment (2023 total)
- 112,911
- EIN
- 361282500
- Establishment ID
- 1140821
- Employer case #
- 79440
When (timing detail)
- Date of incident
- Shift started
- 06:00
- Time of incident
- 11:44
- Filing year
- 2023
- Submitted to OSHA
- 2024-02-21
More injuries at NAI-0032-0032-03775 Fac-03775-Bloomington-Il
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2023. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
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