Injury Line: Columbia-Sussex Corp.
| Inspection Nr | 104292180 |
| Investigation Nr | 737544 |
| Line Nr | 4 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Multiple |
| Source of Injury | Boiler/Press Vessel |
| Event Type | Struck Against |
| Environmental Factor | Flying Object Action |
| Human Factor | Other |
| Occupation | Managers and administrators, n.e.c |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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