East Peoria, IL —
OSHA Injury Report: 021-00705
Injury · Days away from work
At a glance
On , an injury at 021-00705 in East Peoria, IL 61611 resulted in days away from work. Employee was e COMMERCE CLER in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 021-00705
- Parent company
- Kroger Central KMA
- Street
- 201 S Main St
- City
- East Peoria
- State
- IL
- ZIP
- 61611
- On-site location
- GROCERY BACKROOM RECEIVING DOCK
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 1
Before the incident
WALKING AROUND [REDACTED]
What happened
EE tripped on a pallet of [REDACTED] and it was 12inches off floor and he hit his shoulder on the pallet and pain in right knee He hurt his shoulder and his pain level is a 7
Injury or illness
Bruised Right Shoulders Fall on same level FLOOR or PALLET
Object or substance involved
FLOOR PALLET
Summary line
Bruised Right Shoulder Fall on same level FLOOR or PALLET
Employee and industry
- Job description
- e COMMERCE CLER
- SOC code
- 9999 — Uncoded
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2022
- Avg employees
- 100
- Total hours worked
- 144932
- EIN
- 311569568
- Establishment ID
- 963676
- Employer case #
- 854212
When (timing detail)
- Date of incident
- Shift started
- 8:30:00.000
- Time of incident
- 15:40:00.000
- Submitted
- 28FEB24:15:14:00
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.