Bellevue, WI —
OSHA Injury Report: 534-00111
Injury · Other recordable case
At a glance
On , an injury at 534-00111 in Bellevue, WI 54311 resulted in other recordable case. Employee was deli Clerks in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 534-00111
- Parent company
- Roundy's
- Street
- 2064 Lime Kiln Rd
- City
- Bellevue
- State
- WI
- ZIP
- 54311
- On-site location
- DELI DEPT BEHIND SERVICE COUNTER
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
WALKING FROM SOUP BAR TO DELI
What happened
EE WAS WALKING BEHIND THE SERVICE DELI CASE TRIPPED AND FELL AND HIT HER RIGHT SIDE OF HER [REDACTED] INJURIES RIGHT [REDACTED] IS IN PAIN AND BRUISED AS WELL AS THE RIGHT KNEE EE TRIPPED OVER HER OWN FEET
Injury or illness
Bruised Right Elbow Fall on same level FLOOR
Object or substance involved
FLOOR
Summary line
Bruised Right Elbow Fall on same level FLOOR
Employee and industry
- Job description
- Deli Clerks
- SOC code
- 35-3023 — Fast Food and Counter Workers
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2022
- Avg employees
- 151
- Total hours worked
- 156463
- EIN
- 390854535
- Establishment ID
- 966253
- Employer case #
- 850324
When (timing detail)
- Date of incident
- Shift started
- 14:00:00.000
- Time of incident
- 17:00:00.000
- Submitted
- 28FEB24:20:55:00
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.