ROSEVILLE, CA ·
OSHA Injury Report: 0029 - ROSEVILLE CA
Injury · Other recordable case
At a glance
On , an injury at 0029 - ROSEVILLE CA in 6750 STANFORD RANCH ROAD, ROSEVILLE, CA 95210 resulted in other recordable case. Employee was SUP hourly in wholesale Grocer.
Where did this happen?
- Establishment
- 0029 - ROSEVILLE CA
- Parent company
- Costco Wholesale
- Street
- 6750 STANFORD RANCH ROAD
- City
- ROSEVILLE
- State
- CA
- ZIP
- 95210
- On-site location
- SEASONAL
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Chalking line
What happened
[REDACTED] was chalking a line on the floor when an employee moved a t pole that fell onto [REDACTED] s head
Injury or illness
Laceration Head
Object or substance involved
T Bar
Summary line
Laceration Head Struck by a falling or flying object T Bar
Employee and industry
- Job description
- SUP HOURLY
- SOC code
- 41-1011: First-Line Supervisors of Retail Sales Workers
- NAICS code
- 455211: Wholesale Grocer
- NAICS vintage
- 2022
- Employees at this establishment (2023 average)
- 466
- Hours worked at this establishment (2023 total)
- 704,796
- EIN
- 911223280
- Establishment ID
- 1217151
- Employer case #
- WC608G4887
When (timing detail)
- Date of incident
- Shift started
- 02:00
- Time of incident
- 02:13
- Filing year
- 2023
- Submitted to OSHA
- 2024-03-04
More injuries at 0029 - Roseville CA
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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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