FOREST GROVE, OR —
OSHA Injury Report: SWY-0019-0019-00406 FAC-00406-FOREST GROVE-OR
Injury · Other recordable case
At a glance
On , an injury at SWY-0019-0019-00406 FAC-00406-FOREST GROVE-OR in FOREST GROVE, OR 97116 resulted in other recordable case. Employee was deli Clerk in supermarkets and Other Grocery (except Convenience) Stores.
Where did this happen?
- Establishment
- SWY-0019-0019-00406 FAC-00406-FOREST GROVE-OR
- Parent company
- Safeway Inc
- Street
- 2836 PACIFIC AVENUE
- City
- FOREST GROVE
- State
- OR
- ZIP
- 97116
- On-site location
- DELI DEPARTMENT
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
MOPPING FLOOR
What happened
Patient states at work [REDACTED] [REDACTED] thru [REDACTED] he was mopping floors and he slipped and fell on his butt and continued to happen about 4 more time on different days and began to fell back start to develop more pain as time went on .
Injury or illness
Bruised Low back Fall from liquid grease WET FLOOR
Object or substance involved
WET FLOOR
Summary line
Patient states at work [REDACTED] [REDACTED] thru [REDACTED] he was mopping floors and he slipped and fell on his butt and continued to happen about 4 more time on different days and began to fell back start to develop more pain as time went on .
Employee and industry
- Job description
- Deli Clerk
- SOC code
- 35-3023 — Fast Food and Counter Workers
- NAICS code
- 445110 — Supermarkets and Other Grocery (except Convenience) Stores
- NAICS vintage
- 2022
- Avg employees
- 141
- Total hours worked
- 182330
- EIN
- 943019135
- Establishment ID
- 1141276
- Employer case #
- 102245
When (timing detail)
- Date of incident
- Shift started
- 12:00:00.000
- Time of incident
- 12:00:00.000
- Submitted
- 21FEB24:00:36:00
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.