Monona, WI —
OSHA Injury Report: 534-00181
Injury · Other recordable case
At a glance
On , an injury at 534-00181 in Monona, WI 53716 resulted in other recordable case. Employee was e COMMERCE CLER in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 534-00181
- Parent company
- Roundy's
- Street
- 6540 Monona Dr
- City
- Monona
- State
- WI
- ZIP
- 53716
- On-site location
- CLICKLIST BACKROOM
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
WALKING
What happened
EE SLIPPED AND FELL ON A PALLET WHICH CAUSED PAIN TO HIS KNEE INJURIES INFLAMMATION TO THE KNEE
Injury or illness
Sprained Right Knee Fall on same level PALLET or FLOOR
Object or substance involved
PALLET FLOOR
Summary line
Sprained Right Knee Fall on same level PALLET or FLOOR
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
- 124
- Total hours worked
- 136711
- EIN
- 390854535
- Establishment ID
- 966268
- Employer case #
- 866243
When (timing detail)
- Date of incident
- Shift started
- 12:01:00.000
- Time of incident
- 16:00:00.000
- 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.