CLACKAMAS, OR ·
OSHA Injury Report: 0097 - CLACKAMAS OR
Injury · Other recordable case
At a glance
On , an injury at 0097 - CLACKAMAS OR in 13130 SW 84TH AVENUE, CLACKAMAS, OR 97223 resulted in other recordable case. Employee was HA attd NL 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
- OUTSIDE PERIMETER
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Walking into the building before the start of her shift
What happened
Walking from the rear of the building before her shift She turned the corner and ran into a flatbed that was blocking
Injury or illness
Bruise or Contusion Leg Right and Left Side
Object or substance involved
Flatbed
Summary line
Bruise or Contusion Leg Right and Left Side Fall from Different Level Flatbed
Employee and industry
- Job description
- HA ATTD NL
- 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 #
- WC608G8111
When (timing detail)
- Date of incident
- Shift started
- 09:45
- Time of incident
- 09:30
- 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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