Injury Line: Creative Custom Builders, Inc.
| Inspection Nr | 307104950 |
| Investigation Nr | 202353728 |
| Line Nr | 2 |
| Age | |
| Sex |   |
| Nature of Injury | Cut/Laceration |
| Part of Body | Face |
| Source of Injury | Working Surface |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Overhead Moving/Falling Obj Ac |
| Human Factor | Equip. Inappropr For Operation |
| Occupation | Construction laborers |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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