Wautoma, WI —
OSHA Injury Report: 534-00175
Injury · Other recordable case
At a glance
On , an injury at 534-00175 in Wautoma, WI 54982 resulted in other recordable case. Employee was pRODUCE DEPT LE 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
- PRODUCE SALES FLOOR AT BERRY CASE
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
STOCKING PRODUCE
What happened
EE SLIPPED AND FELL FROM ICE FALLING OFF A BOX EE FELL INTO A SLIT AND HURTING HER LOWERBACK
Injury or illness
Strained Posterior Low back Fall on ice orsnow SLIPPERY FLOOR
Object or substance involved
SLIPPERY FLOOR
Summary line
Strained Posterior Low back Fall on ice or snow SLIPPERY FLOOR
Employee and industry
- Job description
- PRODUCE DEPT LE
- SOC code
- 53-7062 — Laborers and Freight, Stock, and Material Movers, Hand
- 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 #
- 857374
When (timing detail)
- Date of incident
- Shift started
- 5:00:00.000
- Time of incident
- 10:00:00.000
- 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.