Injury Line: Shoreline Metal Fabricators Inc
| Inspection Nr | 316143635 |
| Investigation Nr | 201408630 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Head |
| Source of Injury | Bodily Motion |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Heating, air conditioning, and refrig. mechanics |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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