Injury Line: Mark Heard Fuel Co
| Inspection Nr | 1178409 |
| Investigation Nr | 14543086 |
| Line Nr | 2 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Multiple |
| Source of Injury | Motor Vehicle (Hwy) |
| Event Type | Struck By |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Malfunc In Securing/Warning Op |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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