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OSHA Case #:
Employer Information:
Nam Title
e: :
Facts of Accident/Illness
Any property
Accident Investigation Forms Exhibit 9-7 (continued)
damage?
What was the employee doing when the incident occurred? (Please be specific. If
the employee was using tools or equipment or handling material, name them and
explain what the employee was doing with them.)
Explain how the incident occurred. List events that resulted in the injury, what
happened, how it happened, and name tools and objects and how they were
involved.
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