CLACKAMAS, OR ·
OSHA Injury Report: 0097 - CLACKAMAS OR
Injury · Days away from work
At a glance
On , an injury at 0097 - CLACKAMAS OR in 13130 SW 84TH AVENUE, CLACKAMAS, OR 97223 resulted in days away from work. Employee was forklift driver in wholesale Grocer.
Where did this happen?
- Establishment
- 0097 - CLACKAMAS OR
- Parent company
- Costco Wholesale
- Street
- 13130 SW 84TH AVENUE
- City
- CLACKAMAS
- State
- OR
- ZIP
- 97223
- On-site location
- FOOD AND SUNDRY
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 35
- Days restricted or transferred
- 64
Before the incident
stocking paper in the steel
What happened
Employee was stocking paper under steel stood up and hit head on steel
Injury or illness
Concussion Head
Object or substance involved
Steel Load Beams
Summary line
Concussion Head Struck Against a Fixed Object Steel Load Beams
Employee and industry
- Job description
- FORKLIFT DRIVER
- SOC code
- 53-7051: Industrial Truck and Tractor Operators
- NAICS code
- 455211: Wholesale Grocer
- NAICS vintage
- 2022
- Employees at this establishment (2023 average)
- 473
- Hours worked at this establishment (2023 total)
- 699,046
- EIN
- 911223280
- Establishment ID
- 1217100
- Employer case #
- WC608G5032
When (timing detail)
- Date of incident
- Shift started
- 12:00
- Time of incident
- 15:00
- Filing year
- 2023
- Submitted to OSHA
- 2024-03-04
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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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