Wautoma, WI —
OSHA Injury Report: 534-00175
Injury · Days away from work
At a glance
On , an injury at 534-00175 in Wautoma, WI 54982 resulted in days away from work. Employee was bakery manager in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 534-00175
- Parent company
- Roundy's
- Street
- N2573 Plaza Rd
- City
- Wautoma
- State
- WI
- ZIP
- 54982
- On-site location
- BAKERY DEPT- REPETITIVE TRAUMA
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 21
Before the incident
ONGOING WORK DUTIES
What happened
Reported that shoulder was hurting beginning on [REDACTED] to manager [REDACTED] Went to Dr on [REDACTED] or [REDACTED] or [REDACTED] Was put out with restrictions till [REDACTED] or [REDACTED] or [REDACTED]
Injury or illness
Strained Left Shoulders Rubbed or abraded SELF
Object or substance involved
SELF
Summary line
Strained Left Shoulder Rubbed or abraded SELF
Employee and industry
- Job description
- Bakery manager
- SOC code
- 41-1011 — First-Line Supervisors of Retail Sales Workers
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2022
- Avg employees
- 75
- Total hours worked
- 91798
- EIN
- 390854535
- Establishment ID
- 966264
- Employer case #
- 850493
When (timing detail)
- Date of incident
- Shift started
- 5:00:00.000
- Time of incident
- 14:00:00.000
- 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.