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Safety Incidents OSHA Severe Injury Reports · 2015–2025

OSHA Injury Report: 0029 - ROSEVILLE CA

Injury · Other recordable case

On , an injury at 0029 - ROSEVILLE CA in ROSEVILLE, CA 95210 resulted in other recordable case. Employee was sUP HOURLY in wholesale Grocer.

Establishment
0029 - ROSEVILLE CA
Parent company
Costco Wholesale
Street
6750 STANFORD RANCH ROAD
City
ROSEVILLE
State
CA
ZIP
95210
On-site location
SEASONAL
Outcome
Other recordable case (code 4)
Type
Injury (code 1)

Chalking line

[REDACTED] was chalking a line on the floor when an employee moved a t pole that fell onto [REDACTED] s head

Laceration Head

T Bar

Laceration Head Struck by a falling or flying object T Bar

Job description
SUP HOURLY
SOC code
41-1011 — First-Line Supervisors of Retail Sales Workers
NAICS code
455211 — Wholesale Grocer
NAICS vintage
2022
Avg employees
466
Total hours worked
704796
EIN
911223280
Establishment ID
1217151
Employer case #
WC608G4887
Date of incident
Shift started
2:00:00.000
Time of incident
2:13:00.000
Submitted
04MAR24:19:31:00

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.