MAPLE GROVE, MN —
OSHA Injury Report: 0648 - MAPLE GROVE MN
Injury · Other recordable case
At a glance
On , an injury at 0648 - MAPLE GROVE MN in MAPLE GROVE, MN 94063 resulted in other recordable case. Employee was sUP HOURLY in wholesale Grocer.
Where did this happen?
- Establishment
- 0648 - MAPLE GROVE MN
- Parent company
- Costco Wholesale
- Street
- 11330 FOUNTAINS DRIVE NORTH
- City
- MAPLE GROVE
- State
- MN
- ZIP
- 94063
- On-site location
- TIRE SHOP
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
putting tire onto mounter
What happened
working on car tire onto mounter with tool and hand slipped causing the bar to hit
Injury or illness
Bruise or Contusion Head
Object or substance involved
Tool Equipment Unclassified
Summary line
Bruise or Contusion Head Struck by a Moving Object Tool Equipment Unclassified
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
- Avg employees
- 392
- Total hours worked
- 547374
- EIN
- 911223280
- Establishment ID
- 1217193
- Employer case #
- WC413F3401
When (timing detail)
- Date of incident
- Shift started
- 9:00:00.000
- Time of incident
- 15:20:00.000
- Submitted
- 04MAR24:19:36:00
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.