CLACKAMAS, OR ·
OSHA Injury Report: 0097 - CLACKAMAS OR
Injury · Job transfer or restriction
At a glance
On , an injury at 0097 - CLACKAMAS OR in 13130 SW 84TH AVENUE, CLACKAMAS, OR 97223 resulted in job transfer or restriction. Employee was food service 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
- PERISHABLES
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 51
Before the incident
pulling the morning buy for the food court lifting boxes of pizza dough
What happened
Was lifting boxes of pizza dough when felt my lower back tweek
Injury or illness
Strain Sprain Back Lower
Object or substance involved
Merchandise
Summary line
Strain Sprain Back Lower Lifting Merchandise
Employee and industry
- Job description
- FOOD SERVICE
- SOC code
- 9999: Uncoded
- 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 #
- WC608G7136
When (timing detail)
- Date of incident
- Shift started
- 07:30
- Time of incident
- 09:00
- 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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