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MOUNTAIN VIEW, CA —

OSHA Injury Report: 0143 - MOUNTAIN VIEW CA

Injury · Job transfer or restriction

At a glance

On , an injury at 0143 - MOUNTAIN VIEW CA in 1000 N RENGSTORFF, MOUNTAIN VIEW, CA 98027 resulted in job transfer or restriction. Employee was mGR ASST DEPT in wholesale Grocer.

Where did this happen?

Establishment
0143 - MOUNTAIN VIEW CA
Parent company
Costco Wholesale
Street
1000 N RENGSTORFF
City
MOUNTAIN VIEW
State
CA
ZIP
98027
On-site location
RECEIVING

What was the outcome?

Outcome
Job transfer or restriction (code 3)
Type
Injury (code 1)
Days restricted or transferred
58

Before the incident

moving a box

What happened

[REDACTED] was trying to slide a box and as he pulled the box straps snapped causing him to fall

Injury or illness

Bruise or Contusion Arm Left Side

Object or substance involved

Forklift

Summary line

Bruise or Contusion Arm Left Side Fall from Different Level Forklift

Employee and industry

Job description
MGR ASST DEPT
SOC code
9999 — Uncoded
NAICS code
455211 — Wholesale Grocer
NAICS vintage
2022
Avg employees
343
Total hours worked
540990
EIN
911223280
Establishment ID
1217085
Employer case #
WC608G7934

When (timing detail)

Date of incident
Shift started
13:30:00.000
Time of incident
15:30:00.000
Submitted
04MAR24:19:29:00

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Source

Data from OSHA ITA Form 300/301 electronic submissions, filing year unspecified. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.