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Safety Incidents OSHA Severe Injury Reports · 2015–2025

OSHA Injury Report: 534-00396

Respiratory condition · Days away from work

On , a respiratory condition at 534-00396 in 1505 Madison Ave, Fort Atkinson, WI 53538 resulted in days away from work. Employee was dELI CLERK in supermarkets and Other Grocery Except Convenience Stores.

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Establishment
534-00396
Parent company
Roundy's
Street
1505 Madison Ave
City
Fort Atkinson
State
WI
ZIP
53538
On-site location
Deli Bakery
Outcome
Days away from work (code 2)
Type
Respiratory condition (code 3)
Days away from work
5

Performing job duties

EE is alleging contracing COVID 19 while at work

COVID 19 Lungs Pandemic COVID 19

Covid-19

COVID 19 Lungs Pandemic COVID 19

Job description
DELI CLERK
SOC code
35-3023 — Fast Food and Counter Workers
NAICS code
445110 — Supermarkets and Other Grocery Except Convenience Stores
NAICS vintage
2022
Avg employees
128
Total hours worked
116524
EIN
390854535
Establishment ID
966306
Employer case #
24_210741
Date of incident
Filing year
2023
Submitted
28FEB24:20:55:00

View 534-00396's full OSHA safety record →

WM 4464

WM 3385

WM 5373

WM 3497

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.