Injury Line: Quality Tank & Construction Co
| Inspection Nr | 123765414 |
| Investigation Nr | 170132013 |
| Line Nr | 6 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Back |
| Source of Injury | Bodily Motion |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Welders and cutters |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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