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Safety Incidents OSHA Severe Injury Reports · 2015–2025

OSHA Injury Report: 1101 - PEWAUKEE WI

Injury · Other recordable case

On , an injury at 1101 - PEWAUKEE WI in PEWAUKEE, WI 32839 resulted in other recordable case. Employee was fORKLIFT DRIVER in wholesale Grocer.

Establishment
1101 - PEWAUKEE WI
Parent company
Costco Wholesale
Street
443 PEWAUKEE ROAD
City
PEWAUKEE
State
WI
ZIP
32839
On-site location
WALK IN FREEZER
Outcome
Other recordable case (code 4)
Type
Injury (code 1)

Blocking down

I was pulling a box in freezer and felt a sharp pain in my right shoulder

Strain Sprain Shoulder Right Side

Merchandise

Strain Sprain Shoulder Right Side Pulling Merchandise

Job description
FORKLIFT DRIVER
SOC code
53-7051 — Industrial Truck and Tractor Operators
NAICS code
455211 — Wholesale Grocer
NAICS vintage
2022
Avg employees
263
Total hours worked
389666
EIN
911223280
Establishment ID
1217794
Employer case #
WC413F4936
Date of incident
Shift started
18:00:00.000
Time of incident
20:10:00.000
Submitted
04MAR24:19:25:00

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.