Portland, OR —
OSHA Injury Report: Foodservice Pacific NW - 1017
Injury · Days away from work
At a glance
On , an injury at Foodservice Pacific NW - 1017 in 19606 NE San Rafael St, Portland, OR 97230 resulted in days away from work. Employee was driver Formula PFG.
Where did this happen?
- Establishment
- Foodservice Pacific NW - 1017
- Street
- 19606 NE San Rafael St
- City
- Portland
- State
- OR
- ZIP
- 97230
- On-site location
- Foodservice Pacific NW 1017 Door 4
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 46
Before the incident
Fall Slip Same Level
What happened
Driver [REDACTED] tripped over a pallet while cleaning out his returning trailer at the PFS Pac [REDACTED] He fell awkwardly and landed on his rt knee stomach rt arm and hand and left arm and hand He instantly felt a strong pain in his left tricep
Injury or illness
Cause Fall Slip or Trip Injury Body Part Multiple Upper Extremities Body Part Position Detail Cause Fall Slip Same Level
Object or substance involved
Pallet Skids
Summary line
Cause Fall Slip or Trip Injury Body Part Multiple Upper Extremities Body Part Position Detail Cause Fall Slip Same Level
Employee and industry
- Job description
- Driver Formula PFG
- SOC code
- 53-3031 — Driver/Sales Workers
- NAICS code
- 424420
- NAICS vintage
- 2012
- Avg employees
- 160
- Total hours worked
- 332781
- EIN
- 840629503
- Establishment ID
- 205907
- Employer case #
- 1201WC260
When (timing detail)
- Date of incident
- Shift started
- 20:49
- Time of incident
- 1:30
- Filing year
- 2025
- Submitted
- 25FEB26:04:17:00
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View Foodservice Pacific NW - 1017'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.