Waukee, IA —
OSHA Injury Report: 4223-M5900
Injury · Days away from work
At a glance
On , an injury at 4223-M5900 in Waukee, IA 50263 resulted in days away from work. Employee was inventory Control Coordinator in hardware stores.
Where did this happen?
- Establishment
- 4223-M5900
- Parent company
- Fleet Farm Wholesale Supply Co. LLC
- Street
- 1300 SE Kettlestone Blvd
- City
- Waukee
- State
- IA
- ZIP
- 50263
- On-site location
- Parking Lot
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 180
Before the incident
He was carrying a bag of seed outside to throw away
What happened
He went out the small back door slipped on ice falling forward onto both knees hip and shoulder causing injury to both knees left hip left shoulder back and neck.
Injury or illness
Cervicalgia dorsalgia contusion of left knee
Object or substance involved
ice concrete ground
Summary line
Slipped on ice injured both knees left hip left shoulder and neck
Employee and industry
- Job description
- Inventory Control Coordinator
- SOC code
- 53-7065 — Stockers and Order Fillers
- NAICS code
- 444130 — Hardware stores
- NAICS vintage
- 2017
- Avg employees
- 126
- Total hours worked
- 136734
- EIN
- 410806238
- Establishment ID
- 837968
- Employer case #
- 252186
When (timing detail)
- Date of incident
- Shift started
- 4:20:00.000
- Time of incident
- 10:12:00.000
- Submitted
- 29FEB24:14:11:00
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.