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| Inspection Nr | 123332348 |
| Investigation Nr | 200080018 |
| Line Nr | 3 |
| Age | |
| Sex | |
| Nature of Injury | Burn/Scald(Heat) |
| Part of Body | Back |
| Source of Injury | Chem Liquids/Vapors |
| Event Type | Struck By |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Lockout/Tagout Proced Malfunc |
| Occupation | Electricians |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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