FAIRFAX, VA —
OSHA Injury Report: 0204 - FAIRFAX VA
Injury · Days away from work
At a glance
On , an injury at 0204 - FAIRFAX VA in FAIRFAX, VA 22202 resulted in days away from work. Employee was mGR DEPT in wholesale Grocer.
Where did this happen?
- Establishment
- 0204 - FAIRFAX VA
- Parent company
- Costco Wholesale
- Street
- 4725 WEST OX ROAD
- City
- FAIRFAX
- State
- VA
- ZIP
- 22202
- On-site location
- BAKERY
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 47
- Days restricted or transferred
- 6
Before the incident
working
What happened
[REDACTED] was on a ladder inside of Bakery Freezer hurting his right shoulder and RT side of back
Injury or illness
Bruise or Contusion Shoulder Right Side
Object or substance involved
Ladder Stepstool
Summary line
Bruise or Contusion Shoulder Right Side Fall from ladder stepstool Ladder Stepstool
Employee and industry
- Job description
- MGR DEPT
- SOC code
- 41-1012 — First-Line Supervisors of Non-Retail Sales Workers
- NAICS code
- 455211 — Wholesale Grocer
- NAICS vintage
- 2022
- Avg employees
- 418
- Total hours worked
- 601992
- EIN
- 911223280
- Establishment ID
- 1217901
- Employer case #
- WC80DG3240
When (timing detail)
- Date of incident
- Shift started
- 12:00:00.000
- Time of incident
- 18:35:00.000
- Submitted
- 04MAR24:19:30:00
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.