Injury Line: Chevron Stations, Inc. Dba Chevron Station #1597
| Inspection Nr | 316521079 |
| Investigation Nr | 202493904 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Head |
| Source of Injury | Bodily Motion |
| Event Type | Fall(Same Level) |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Other |
| Occupation | Cashiers |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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