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ACCIDENT, INJURY & IL NESS INVESTIGATION <br /> i <br /> I. Description <br /> Location/Address: <br /> Person(s)/Titles(s) Conducting Investigation: <br /> r-. <br /> Date and Time of Accident/Injury/Illness: <br /> Name(s) of Affected Employee(s): Part(s) of Body Affected: <br /> Nature of Accident/Injury/Illness: <br /> What Workplace Condition, Work Practice or Protective Equipment Contributed to the Accident: <br /> E <br /> i <br /> Was a Code of Safe Practice Violated? <br /> ❑ Yes ❑ No <br /> If Yes, Which One? <br />