Appleton, WI —
OSHA Injury Report: 534-00403
Injury · Other recordable case
At a glance
On , an injury at 534-00403 in N135 Stoney Brook Rd, Appleton, WI 54915 resulted in other recordable case. Employee was fRONT END LEAD in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 534-00403
- Parent company
- Roundy's
- Street
- N135 Stoney Brook Rd
- City
- Appleton
- State
- WI
- ZIP
- 54915
- On-site location
- PARKING LOT
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
HELPING A CUSTOMER
What happened
EE STATED SHE WAS HELPING A CM IN THE PARKING LOT AND TRIPPED IN A POTHOLE AND FELL TO THE GROUND AND INJURED HER RIGHT HANDCM INJURED RIGHT HAND BRUISE
Injury or illness
Bruised Right Hand Fall GROUND
Object or substance involved
GROUND
Summary line
EE STATED SHE WAS HELPING A CM IN THE PARKING LOT AND TRIPPED IN A POTHOLE AND FELL TO THE GROUND AN
Employee and industry
- Job description
- FRONT END LEAD
- SOC code
- 00-9900 — Insufficient Information - NIOSH
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2012
- Avg employees
- 100
- Total hours worked
- 122137
- EIN
- 390854535
- Establishment ID
- 966309
- Employer case #
- 909905
When (timing detail)
- Date of incident
- Shift started
- 8:00
- Time of incident
- 9:30
- Filing year
- 2025
- Submitted
- 17FEB26:14:50:00
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View 534-00403'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.