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Safety Incidents OSHA Severe Injury Reports · 2015–2025

MENOMONEE FALLS, WI —

OSHA Injury Report: 1209 - MENOMONEE FALLS WI

Injury · Other recordable case

At a glance

On , an injury at 1209 - MENOMONEE FALLS WI in W162 N9235 PERSHING AVE, MENOMONEE FALLS, WI 43228 resulted in other recordable case. Employee was sERVICE DELI CLERK in wHOLESALE GROCER.

Where did this happen?

Establishment
1209 - MENOMONEE FALLS WI
Parent company
Costco Wholesale
Street
W162 N9235 PERSHING AVE
City
MENOMONEE FALLS
State
WI
ZIP
43228
On-site location
SERVICE DELI

What was the outcome?

Outcome
Other recordable case (code 4)
Type
Injury (code 1)

Before the incident

Cleaning the Floor

What happened

Tripped over hose of foamer and fell into the splits and over stretched right leg muscle

Injury or illness

Strain Sprain Leg Right Side

Object or substance involved

Tool Equipment Unclassified

Summary line

Strain Sprain Leg Right Side Caught by Fixed Object Tool Equipment Unclassified

Employee and industry

Job description
SERVICE DELI CLERK
SOC code
35-3023 — Fast Food and Counter Workers
NAICS code
455211 — WHOLESALE GROCER
NAICS vintage
2022
Avg employees
248
Total hours worked
366215
EIN
911223280
Establishment ID
1217710
Employer case #
WC413F4338

When (timing detail)

Date of incident
Shift started
14:00:00.000
Time of incident
21:23:00.000
Filing year
2023
Submitted
04MAR24:19:27:00

More injuries at 1209 - MENOMONEE FALLS WI

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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.