Injury Line: Champion International
| Inspection Nr | 100020742 |
| Investigation Nr | 14431936 |
| Line Nr | 2 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Bodysystem |
| Source of Injury | Petroleum Products |
| Event Type | Other |
| Environmental Factor | Other |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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