Injury Line: Pep Boys - Manny, Moe & Jack Of Delaware, Inc.
| Inspection Nr | 1234395.015 |
| Investigation Nr | 95764.015 |
| Line Nr | 1 |
| Age | 54 |
| Sex | M |
| Nature of Injury |   |
| Part of Body |   |
| Source of Injury |   |
| Event Type | Other |
| Environmental Factor |   |
| Human Factor |   |
| Occupation | Automobile mechanic apprentices |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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