MIDDLEBURY, VT —
OSHA Injury Report: NAI-0033-0033-01219 FAC-01219-MIDDLEBURY-VT
Injury · Other recordable case
At a glance
On , an injury at NAI-0033-0033-01219 FAC-01219-MIDDLEBURY-VT in MIDDLEBURY, VT 05753 resulted in other recordable case. Employee was deli Clerk in supermarkets and Other Grocery (except Convenience) Stores.
Where did this happen?
- Establishment
- NAI-0033-0033-01219 FAC-01219-MIDDLEBURY-VT
- Parent company
- Shaw's Supermarkets, Inc
- Street
- 8 WASHINGTON ST.
- City
- MIDDLEBURY
- State
- VT
- ZIP
- 05753
- On-site location
- DELI
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
PRODUCT TRANSFER MATERIAL HANDLING
What happened
EE was walking into the deli and tripped on the carpet that is laying across the flooring transition. She fell and hit her face
Injury or illness
Fracture Mouth Fall FLOOR
Object or substance involved
FLOOR
Summary line
EE was walking into the deli and tripped on the carpet that is laying across the flooring transition. She fell and hit her face
Employee and industry
- Job description
- Deli Clerk
- SOC code
- 35-3023 — Fast Food and Counter Workers
- NAICS code
- 445110 — Supermarkets and Other Grocery (except Convenience) Stores
- NAICS vintage
- 2022
- Avg employees
- 72
- Total hours worked
- 101729
- EIN
- 41123420
- Establishment ID
- 1141702
- Employer case #
- 78629
When (timing detail)
- Date of incident
- Shift started
- 6:52:00.000
- Time of incident
- 10:00:00.000
- Submitted
- 29FEB24:01:03:00
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.