Injury Line: Southern California Discount Tire Inc Co Dba Disco
| Inspection Nr | 315344341 |
| Investigation Nr | 201077930 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Concussion |
| Part of Body | Head |
| Source of Injury | Working Surface |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Other |
| Human Factor | Mater-Handlg Proced. Inappropr |
| Occupation | Not specified mechanics and repairers |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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