CLINTON, TN —
OSHA Injury Report: 654 FC CLINTON TN
Injury · Days away from work
At a glance
On , an injury at 654 FC CLINTON TN in 507 SOUTH CHARLES G SEVIERS BOULEVA, CLINTON, TN 377162723 resulted in days away from work. Employee was fuel Clerk Over in supermarket.
Where did this happen?
- Establishment
- 654 FC CLINTON TN
- Parent company
- K VA T Food Stores Inc.
- Street
- 507 SOUTH CHARLES G SEVIERS BOULEVA
- City
- CLINTON
- State
- TN
- ZIP
- 377162723
- On-site location
- Gas N Go
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 180
Before the incident
walking out of kiosk
What happened
Walking out of gas n go kiosk fell
Injury or illness
R humerus and L olecranon fractures hematoma head
Object or substance involved
None known
Summary line
R humerus and L olecranon fractures hematoma head None known Leaving the gas n go kiosk when she fell
Employee and industry
- Job description
- Fuel Clerk Over
- SOC code
- 53-7065 — Stockers and Order Fillers
- NAICS code
- 445110 — Supermarket
- NAICS vintage
- 2022
- Avg employees
- 135
- Total hours worked
- 186014
- EIN
- 550421484
- Establishment ID
- 1293465
- Employer case #
- 80300
When (timing detail)
- Date of incident
- Shift started
- 11:00
- Time of incident
- 11:56
- Filing year
- 2025
- Submitted
- 16JAN26:21:04:00
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View 654 FC CLINTON TN's full OSHA safety record →
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2025. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.