FOND DU LAC, WI —
OSHA Injury Report: 534-00389
Injury · Days away from work
At a glance
On , an injury at 534-00389 in FOND DU LAC, WI 54935 resulted in days away from work. Employee was e COMMERCE DEPA in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 534-00389
- Parent company
- Roundy's
- Street
- 760 W Johnson St
- City
- FOND DU LAC
- State
- WI
- ZIP
- 54935
- On-site location
- GROCERY-BACKROOM
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 2
- Days restricted or transferred
- 98
Before the incident
REACHING FOR 12 PACK OF SODA
What happened
The EE was reaching for a 12 pack of soda when she tripped on a pallet jack behind her which caused her to fall onto her tailbone The EE did not sustain any injuries However the [REDACTED] stated the EE believes that she fractured her tailbone because s
Injury or illness
Bruised Posterior Tailbone Fall FLOOR
Object or substance involved
FLOOR
Summary line
Bruised Posterior Tailbone Fall FLOOR
Employee and industry
- Job description
- e COMMERCE DEPA
- 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
- 129
- Total hours worked
- 150709
- EIN
- 390854535
- Establishment ID
- 966301
- Employer case #
- 860275
When (timing detail)
- Date of incident
- Shift started
- 7:30:00.000
- Time of incident
- 8:55:00.000
- 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.