Injury Line: Mr. Bult'S, Inc.
| Inspection Nr | 1303629.015 |
| Investigation Nr | 104082.015 |
| Line Nr | 1 |
| Age | 48 |
| Sex | M |
| Nature of Injury |   |
| Part of Body |   |
| Source of Injury |   |
| Event Type | Struck By |
| Environmental Factor |   |
| Human Factor |   |
| Occupation | Truck Driver: Heavy/Tractor-Trailer |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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