CLACKAMAS, OR —
OSHA Injury Report: 0097 - CLACKAMAS OR
Injury · Other recordable case
At a glance
On , an injury at 0097 - CLACKAMAS OR in CLACKAMAS, OR 97223 resulted in other recordable case. Employee was sERVICE DELI CLERK 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
- SERVICE DELI
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
walking into the cooler from the raw room
What happened
Walking though the raw room to the cooler the employee stepped in the floor drain that had not been covered
Injury or illness
Bruise or Contusion Ankle Left Side
Object or substance involved
Floor Walking Surface
Summary line
Bruise or Contusion Ankle Left Side Fall on uneven surface Floor Walking Surface
Employee and industry
- Job description
- SERVICE DELI CLERK
- SOC code
- 35-3023 — Fast Food and Counter Workers
- NAICS code
- 455211 — Wholesale Grocer
- NAICS vintage
- 2022
- Avg employees
- 473
- Total hours worked
- 699046
- EIN
- 911223280
- Establishment ID
- 1217100
- Employer case #
- WC608G8169
When (timing detail)
- Date of incident
- Shift started
- 4:00:00.000
- Time of incident
- 4:15:00.000
- Submitted
- 04MAR24:19:40:00
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.