SANTA ROSA, CA ·
OSHA Injury Report: 0041 - SANTA ROSA CA
Injury · Job transfer or restriction
At a glance
On , an injury at 0041 - SANTA ROSA CA in 1900 SANTA ROSA AVENUE, SANTA ROSA, CA 99508 resulted in job transfer or restriction. Employee was tire installer in wholesale Grocer.
Where did this happen?
- Establishment
- 0041 - SANTA ROSA CA
- Parent company
- Costco Wholesale
- Street
- 1900 SANTA ROSA AVENUE
- City
- SANTA ROSA
- State
- CA
- ZIP
- 99508
- On-site location
- TIRE SHOP
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 7
Before the incident
walking near tire maching working on member vehicle
What happened
EE struck his elbow against tire machine and caused swelling bursa
Injury or illness
Bruise or Contusion Elbow Right Side
Object or substance involved
Tire Changer
Summary line
Bruise or Contusion Elbow Right Side Caught by Fixed Object Tire Changer
Employee and industry
- Job description
- TIRE INSTALLER
- SOC code
- 49-3093: Tire Repairers and Changers
- NAICS code
- 455211: Wholesale Grocer
- NAICS vintage
- 2022
- Employees at this establishment (2023 average)
- 396
- Hours worked at this establishment (2023 total)
- 624,821
- EIN
- 911223280
- Establishment ID
- 1217034
- Employer case #
- WC608G7971
When (timing detail)
- Date of incident
- Shift started
- 12:15
- Time of incident
- 17:00
- Filing year
- 2023
- Submitted to OSHA
- 2024-03-04
More injuries at 0041 - Santa Rosa 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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