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Safety Incidents OSHA Severe Injury Reports · 2015–2025

MARYSVILLE, WA —

OSHA Injury Report: 0642 - MARYSVILLE WA

Injury · Other recordable case

At a glance

On , an injury at 0642 - MARYSVILLE WA in 16616 TWIN LAKES AVENUE, MARYSVILLE, WA 83201 resulted in other recordable case. Employee was mGR DEPT in wholesale Grocer.

Where did this happen?

Establishment
0642 - MARYSVILLE WA
Parent company
Costco Wholesale
Street
16616 TWIN LAKES AVENUE
City
MARYSVILLE
State
WA
ZIP
83201
On-site location
TIRE SHOP

What was the outcome?

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

Before the incident

mounting a tire in the tire shop

What happened

Stood up and was hit by tire mount arm being swung back

Injury or illness

Concussion Head

Object or substance involved

Tire Balancer

Summary line

Concussion Head Caught In or Between Tire Balancer

Employee and industry

Job description
MGR DEPT
SOC code
41-1012 — First-Line Supervisors of Non-Retail Sales Workers
NAICS code
455211 — Wholesale Grocer
NAICS vintage
2022
Avg employees
301
Total hours worked
432153
EIN
911223280
Establishment ID
1217397
Employer case #
SX14830

When (timing detail)

Date of incident
Shift started
9:00:00.000
Time of incident
12:45:00.000
Submitted
04MAR24:19:36:00

More injuries at 0642 - MARYSVILLE WA

View 0642 - MARYSVILLE WA's full OSHA safety record →

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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.