Injury Line: Calvin J. Moss Construction
| Inspection Nr | 105612014 |
| Investigation Nr | 971432 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Legs |
| Source of Injury | Ladder |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Weather, Earthquake, Etc. |
| Human Factor | Safety Devices Removed/Inoper. |
| Occupation | Construction laborers |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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