Derby, KS —
OSHA Injury Report: 615-00083
Injury · Days away from work
At a glance
On , an injury at 615-00083 in 1624 N Rock Rd, Derby, KS 67037 resulted in days away from work. Employee was office Clerks in warehouse Clubs and Supercenters.
Where did this happen?
- Establishment
- 615-00083
- Parent company
- Dillon Stores
- Street
- 1624 N Rock Rd
- City
- Derby
- State
- KS
- ZIP
- 67037
- On-site location
- FRONT END SIDEWALK IN FRONT OF STORE
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 4
Before the incident
RETURNING TO STORE AFTER FUEL CENTER DEPOSIT
What happened
[REDACTED] stated the [REDACTED] was walking from the field center The [REDACTED] fell striking the pavement street resulting in a laceration LT temple above the LT eyebrow severe swelling LT temple LT side from waist up is sore and bruised
Injury or illness
Lacerated Anterior Face Fall on same level GROUND
Object or substance involved
GROUND
Summary line
Lacerated Anterior Face Fall on same level GROUND
Employee and industry
- Job description
- Office Clerks
- SOC code
- 43-9061 — Office Clerks, General
- NAICS code
- 455211 — Warehouse Clubs and Supercenters
- NAICS vintage
- 2022
- Avg employees
- 223
- Total hours worked
- 282193
- EIN
- 480196590
- Establishment ID
- 966441
- Employer case #
- 861665
When (timing detail)
- Date of incident
- Shift started
- 5:00:00.000
- Time of incident
- 6:20:00.000
- Filing year
- 2023
- Submitted
- 28FEB24:21:05:00
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View 615-00083's full OSHA safety record →
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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.