Shelburne, VT —
OSHA Injury Report: Tractor Supply Company Store 1490
Injury · Other recordable case
At a glance
On , an injury at Tractor Supply Company Store 1490 in Shelburne, VT 05482 resulted in other recordable case. Employee was store Manager in general Merchandise Stores.
Where did this happen?
- Establishment
- Tractor Supply Company Store 1490
- Parent company
- Tractor Supply Company
- Street
- 3708 Shelburne Rd
- City
- Shelburne
- State
- VT
- ZIP
- 05482
- On-site location
- Parking Lot
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Using A Crowbar To Assemble A Trailer
What happened
The Ee Was Using A Crowbar To Assemble A Trailer In The Parking Lot When It Slipped And Struck His Face. As A Result He Broke His 2 Front Teeth And Has A Deep Laceration To His Jaw.
Injury or illness
Multiple Physical Injuries Only-Multiple Body Parts (Including Body Systems & Body Parts)
Object or substance involved
Store Equipment
Summary line
TM Struck or Against Store Equipment in the Parking Lot causing Multiple Physical Injuries Only of the Multiple Body Parts
Employee and industry
- Job description
- Store Manager
- SOC code
- 41-1011 — First-Line Supervisors of Retail Sales Workers
- NAICS code
- 444240 — General Merchandise Stores
- NAICS vintage
- 2022
- Avg employees
- 17
- Total hours worked
- 18498
- EIN
- 884210417
- Establishment ID
- 741925
- Employer case #
- 0041690757
When (timing detail)
- Date of incident
- Shift started
- 7:00:00.000
- Time of incident
- 17:05:00.000
- Submitted
- 04MAR24:04:35:00
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.