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| Inspection Nr | 2795888 |
| Investigation Nr | 783936 |
| Line Nr | 3 |
| Age | |
| Sex | |
| Nature of Injury | Fracture |
| Part of Body | Multiple |
| Source of Injury | Fire/Smoke |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Insuff/Lack/Housekeeping Program |
| Occupation | Supervisors; handlers,equip-cleaners,laborers nec |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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