GRAND CHUTE, WI —
OSHA Injury Report: 1222 - GRAND CHUTE WI
Injury · Other recordable case
At a glance
On , an injury at 1222 - GRAND CHUTE WI in GRAND CHUTE, WI 44109 resulted in other recordable case. Employee was mGR DEPT W OT in wHOLESALE GROCER.
Where did this happen?
- Establishment
- 1222 - GRAND CHUTE WI
- Parent company
- Costco Wholesale
- Street
- 5401 W INTEGRITY WAY
- City
- GRAND CHUTE
- State
- WI
- ZIP
- 44109
- On-site location
- FOOD COURT
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Putting together yogurt machine
What happened
Thumb slid across metal vent
Injury or illness
Laceration Thumb Left Side
Object or substance involved
Food Court Yogurt Machine
Summary line
Laceration Thumb Left Side Caught In or Between Food Court Yogurt Machine
Employee and industry
- Job description
- MGR DEPT W OT
- SOC code
- 9999 — Uncoded
- NAICS code
- 455211 — WHOLESALE GROCER
- NAICS vintage
- 2022
- Avg employees
- 253
- Total hours worked
- 381565
- EIN
- 911223280
- Establishment ID
- 1217701
- Employer case #
- WC413F6053
When (timing detail)
- Date of incident
- Shift started
- 7:30:00.000
- Time of incident
- 9:45:00.000
- Submitted
- 04MAR24:19:27:00
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.