Injury Line: Performance Contracting Inc
| Inspection Nr | 111458212 |
| Investigation Nr | 170236863 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Back |
| Source of Injury | Dirt/Sand/Stone |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Overhead Moving/Falling Obj Ac |
| Human Factor | Malfunc In Securing/Warning Op |
| Occupation | Occupation not reported |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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