EVERETT, WA ·
OSHA Injury Report: 0114 - EVERETT WA
Injury · Days away from work
At a glance
On , an injury at 0114 - EVERETT WA in 10200 19TH AVENUE SE, EVERETT, WA 92243 resulted in days away from work. Employee was service deli clerk in wholesale Grocer.
Where did this happen?
- Establishment
- 0114 - EVERETT WA
- Parent company
- Costco Wholesale
- Street
- 10200 19TH AVENUE SE
- City
- EVERETT
- State
- WA
- ZIP
- 92243
- On-site location
- Deli Chicken room
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 1
Before the incident
Taking item to member
What happened
Walking through chicken room Slipped and fell hitting head on hand wash sink
Injury or illness
Laceration Head
Object or substance involved
Floor Walking Surface
Summary line
Laceration Head Fall from Same Level Floor Walking Surface
Employee and industry
- Job description
- SERVICE DELI CLERK
- SOC code
- 35-3023: Fast Food and Counter Workers
- NAICS code
- 455211: Wholesale Grocer
- NAICS vintage
- 2022
- Employees at this establishment (2023 average)
- 320
- Hours worked at this establishment (2023 total)
- 458,078
- EIN
- 911223280
- Establishment ID
- 1217242
- Employer case #
- SY62998
When (timing detail)
- Date of incident
- Shift started
- 14:00
- Time of incident
- 20:10
- Filing year
- 2023
- Submitted to OSHA
- 2024-03-04
More injuries at 0114 - Everett WA
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2023. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
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