EVERETT, WA ·
OSHA Injury Report: 0114 - EVERETT WA
Injury · Job transfer or restriction
At a glance
On , an injury at 0114 - EVERETT WA in 10200 19TH AVENUE SE, EVERETT, WA 92243 resulted in job transfer or restriction. Employee was bakery wrapper 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
- BAKERY
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 131
Before the incident
cleaning bakery
What happened
Was mopping and walked backwards and fell R leg in and L leg half way in dishwasher pit Bumped head and back
Injury or illness
Strain Sprain Back Lower Right and Left Side
Object or substance involved
Tool Equipment Unclassified
Summary line
Strain Sprain Back Lower Right and Left Side Fall from Different Level Tool Equipment Unclassified
Employee and industry
- Job description
- BAKERY WRAPPER
- SOC code
- 53-7064: Packers and Packagers, Hand
- 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 #
- SY63479
When (timing detail)
- Date of incident
- Shift started
- 13:45
- Time of incident
- 18:50
- 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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