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Safety Incidents OSHA Severe Injury Reports · 2015–2025

OSHA Injury Report: 0041 - SANTA ROSA CA

Injury · Job transfer or restriction

On , an injury at 0041 - SANTA ROSA CA in SANTA ROSA, CA 99508 resulted in job transfer or restriction. Employee was tIRE INSTALLER in wholesale Grocer.

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
Outcome
Job transfer or restriction (code 3)
Type
Injury (code 1)
Days restricted or transferred
7

walking near tire maching working on member vehicle

EE struck his elbow against tire machine and caused swelling bursa

Bruise or Contusion Elbow Right Side

Tire Changer

Bruise or Contusion Elbow Right Side Caught by Fixed Object Tire Changer

Job description
TIRE INSTALLER
SOC code
49-3093 — Tire Repairers and Changers
NAICS code
455211 — Wholesale Grocer
NAICS vintage
2022
Avg employees
396
Total hours worked
624821
EIN
911223280
Establishment ID
1217034
Employer case #
WC608G7971
Date of incident
Shift started
12:15:00.000
Time of incident
17:00:00.000
Submitted
04MAR24:19:34:00

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.