Injury Line: Jim Burke Ford
| Inspection Nr | 310822804 |
| Investigation Nr | 201089489 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Burn/Scald(Heat) |
| Part of Body | Arm-Mult |
| Source of Injury | Boxes/Barrels, Etc. |
| Event Type | Absorption |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Janitors and cleaners |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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