Injury Line: Menter Sand & Gravel Inc
| Inspection Nr | 114625270 |
| Investigation Nr | 14559967 |
| Line Nr | |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Head |
| Source of Injury | Bodily Motion |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Position Inapropriate For Task |
| Occupation | Paving, surfacing and tamping equipment operators |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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