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Safety Incidents OSHA Severe Injury Reports · 2015–2025

OSHA Injury Report: 0775 - POWAY CA

Injury · Other recordable case

On , an injury at 0775 - POWAY CA in POWAY, CA 43240 resulted in other recordable case. Employee was mGR DEPT W OT in wholesale Grocer.

Establishment
0775 - POWAY CA
Parent company
Costco Wholesale
Street
12155 TECH CENTER DRIVE
City
POWAY
State
CA
ZIP
43240
On-site location
TIRE SHOP
Outcome
Other recordable case (code 4)
Type
Injury (code 1)

Working

Taking tire off of wheel and grab bar flew into forehead above left eye

Laceration Forehead Left Side

Tire Changer

Laceration Forehead Left Side Pulling Tire Changer

Job description
MGR DEPT W OT
SOC code
9999 — Uncoded
NAICS code
455211 — Wholesale Grocer
NAICS vintage
2022
Avg employees
334
Total hours worked
507669
EIN
911223280
Establishment ID
1217707
Employer case #
WC608G7272
Date of incident
Shift started
8:30:00.000
Time of incident
15:40:00.000
Submitted
04MAR24:19:39:00

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.