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GRANGER, IN —

OSHA Injury Report: 1183 - MISHAWAKA IN

Injury · Job transfer or restriction

At a glance

On , an injury at 1183 - MISHAWAKA IN in 625 E UNIVERSITY DRIVE, GRANGER, IN 60523 resulted in job transfer or restriction. Employee was tIRE INSTALLER in wholesale Grocer.

Where did this happen?

Establishment
1183 - MISHAWAKA IN
Parent company
Costco Wholesale
Street
625 E UNIVERSITY DRIVE
City
GRANGER
State
IN
ZIP
60523
On-site location
TIRE SHOP

What was the outcome?

Outcome
Job transfer or restriction (code 3)
Type
Injury (code 1)
Days restricted or transferred
10

Before the incident

painting a bottom of door rust

What happened

Stood up took step ahead felt pain in left knee to foot

Injury or illness

Unknown Knee Left Side

Object or substance involved

Tool Equipment Unclassified

Summary line

Unknown Knee Left Side Work Place Environment Tool Equipment Unclassified

Employee and industry

Job description
TIRE INSTALLER
SOC code
49-3093 — Tire Repairers and Changers
NAICS code
455211 — Wholesale Grocer
NAICS vintage
2022
Avg employees
323
Total hours worked
462182
EIN
911223280
Establishment ID
1217561
Employer case #
WC80DG1952

When (timing detail)

Date of incident
Shift started
9:45:00.000
Time of incident
15:30:00.000
Filing year
2023
Submitted
04MAR24:19:26:00

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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.