Fond du Lac, WI —
OSHA Injury Report: 534-00472
Injury · Days away from work
At a glance
On , an injury at 534-00472 in Fond du Lac, WI 54935 resulted in days away from work. Employee was cUSTOMER SVC DE in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 534-00472
- Parent company
- Roundy's
- Street
- 55 W Pioneer Rd
- City
- Fond du Lac
- State
- WI
- ZIP
- 54935
- On-site location
- PARKING LOT
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 68
Before the incident
WALKING
What happened
EE SLIPPED ON ICE AND FELL IN THE PARKING LOT CM THEN PASSED OUT 20MIN [REDACTED] AFTER PUNCHING IN CM WAS TRANSPORTED BY AMBULANCE CM ALSO HAS SORE WRIST
Injury or illness
Fracture Left Wrist Fall ICEY GROUND
Object or substance involved
ICEY GROUND
Summary line
Fracture Left Wrist Fall ICEY GROUND
Employee and industry
- Job description
- CUSTOMER SVC DE
- SOC code
- 43-4051 — Customer Service Representatives
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2022
- Avg employees
- 131
- Total hours worked
- 142510
- EIN
- 390854535
- Establishment ID
- 966327
- Employer case #
- 849588
When (timing detail)
- Date of incident
- Shift started
- 5:00:00.000
- Time of incident
- 5:45:00.000
- 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.