Abstract: At 3:20 p.m. on June 4, 2012, Employee #1 was part of a team working to repair and replace the lining of underground fuel tanks. The team was scraping and sandblasting the interior lining of the concrete tanks. This work was occurring at a military base in San Pedro, CA. The tank the team was working on had a capacity of two million gallons of marine grade diesel fuel. Employee #1 was working at grade level, assuring that the sand blast pot was kept full. He had complained the night before that he did not feel well. On the morning of the incident, he complained that he still did not feel well. His foreman, Employee #2, asked if he would like to return to his motel room. He refused, and after lunch he stated that he was feeling a little better. At approximately 3:00 p.m., his partner, Employee #3, went to get some more sand. Upon his return, he found Employee #1 lying face down with his hands at his sides and legs straight out. Employee #1 was unresponsive and did not have a pulse. Another team member, Employee #4, initiated CPR until paramedics arrived. Ultimately, Employee #1 was pronounced dead by the paramedics. His surface injuries indicated that he had fallen on his face. He had trauma to his nose and left eyebrow from the fall. The investigation report cites a possible heart attack. The coroner subsequently determined that this fatality was due to a chronic medical condition. This incident was reported to the Torrance office of Cal/OSHA by the Los Angeles Fire Department at 4:00 p.m. on June 5, 2012. A Cal/OSHA investigator responded immediately and arrived on site at 4:20 p.m. Because the site is a military base, an opening conference was held with the base commander and a foreman for the employer. Both gave permission to continue the inspection. The employer, ABHE & Svoboda Inc., Alpine, CA, is a contractor specializing in custom paint coatings.