Delavan, WI —
OSHA Injury Report: 484 Delavan
Injury · Other recordable case
At a glance
On , an injury at 484 Delavan in 1921 E Geneva St, Delavan, WI 53115 resulted in other recordable case. Employee was shoe Supervisor in department Stores.
Where did this happen?
- Establishment
- 484 Delavan
- Parent company
- Kohls Department Stores
- Street
- 1921 E Geneva St
- City
- Delavan
- State
- WI
- ZIP
- 53115
- On-site location
- Salesfloor
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Replenishment
What happened
suffered laceration puncture on left forearm after hitting display hook
Injury or illness
Puncture - Upper Extremities - Lower Arm
Object or substance involved
Fixture Display
Summary line
suffered laceration puncture on left forearm after hitting display hook
Employee and industry
- Job description
- Shoe Supervisor
- SOC code
- 41-1011 — First-Line Supervisors of Retail Sales Workers
- NAICS code
- 452210 — Department Stores
- NAICS vintage
- 2017
- Avg employees
- 60
- Total hours worked
- 63906
- EIN
- 133357362
- Establishment ID
- 1111357
- Employer case #
- K-23-07964
When (timing detail)
- Date of incident
- Time of incident
- 0:00:00.000
- Filing year
- 2023
- Submitted
- 20FEB24:17:18:00
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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 — no per-record IMIS deep link exists.