Injury Line: Nc Dot, Maintenance Unit, Division 8, District 3
| Inspection Nr | 3033750 |
| Investigation Nr | 759779 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Multiple |
| Source of Injury | Motor Vehicle(Indus) |
| Event Type | Struck By |
| Environmental Factor | Squeeze Point Action |
| Human Factor | Insuff/Lack/Writn Wrk Prac Prog. |
| Occupation | Motor transportation occuputions n.e.c. |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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